| National Provider Identifier [NPI]: | 1730179722 |
| Last Name Of The Provider | GIMINARO |
| First Name Of The Provider | VINCENT |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2012 S TOLLGATE RD |
| Street Address 2 Of The Provider | STE 111 |
| City Of The Provider | BEL AIR |
| Zip Code Of The Provider | 210155900 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 3768 |
| Number Of Medicare Beneficiaries | 520 |
| Total Submitted Charge Amount | 347477.5 |
| Total Medicare Allowed Amount | 227502.52 |
| Total Medicare Payment Amount | 164801.67 |
| Total Medicare Standardized Payment Amount | 154091.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 349 |
| Number Of Medicare Beneficiaries With Drug Services | 217 |
| Total Drug Submitted ChargeAmount | 7785.5 |
| Total Drug Medicare AllowedAmount | 4532.98 |
| Total Drug Medicare PaymentAmount | 4369.83 |
| Total Drug Medicare Standardized Payment Amount | 4369.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 3419 |
| Number Of Medicare Beneficiaries With Medical Services | 520 |
| Total Medical Submitted Charge Amount | 339692 |
| Total Medical Medicare Allowed Amount | 222969.54 |
| Total Medical Medicare Payment Amount | 160431.84 |
| Total Medical Medicare Standardized Payment Amount | 149721.82 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 223 |
| Number Of Beneficiaries Age 75 to 84 | 166 |
| Number Of Beneficiaries Age Greater 84 | 103 |
| Number Of Female Beneficiaries | 309 |
| Number Of Male Beneficiaries | 211 |
| Number Of Non Hispanic White Beneficiaries | 486 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 486 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4658 |