| National Provider Identifier [NPI]: | 1568560134 |
| Last Name Of The Provider | GIANGERUSO |
| First Name Of The Provider | ENRICO |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2411 W BELVEDERE AVE |
| Street Address 2 Of The Provider | STE 306 |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212155228 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 28762 |
| Number Of Medicare Beneficiaries | 5432 |
| Total Submitted Charge Amount | 3765104.95 |
| Total Medicare Allowed Amount | 1549197.78 |
| Total Medicare Payment Amount | 1195642.86 |
| Total Medicare Standardized Payment Amount | 765418.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 28762 |
| Number Of Medicare Beneficiaries With Medical Services | 5432 |
| Total Medical Submitted Charge Amount | 3765104.95 |
| Total Medical Medicare Allowed Amount | 1549197.78 |
| Total Medical Medicare Payment Amount | 1195642.86 |
| Total Medical Medicare Standardized Payment Amount | 765418.53 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 514 |
| Number Of Beneficiaries Age 65 to 74 | 3057 |
| Number Of Beneficiaries Age 75 to 84 | 1565 |
| Number Of Beneficiaries Age Greater 84 | 296 |
| Number Of Female Beneficiaries | 2921 |
| Number Of Male Beneficiaries | 2511 |
| Number Of Non Hispanic White Beneficiaries | 3789 |
| Number Of Black or African American Beneficiaries | 1296 |
| Number Of AsianPacific Islander Beneficiaries | 153 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 124 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4875 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 557 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9343 |