| National Provider Identifier [NPI]: | 1669563128 |
| Last Name Of The Provider | MANCUSO |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1307 FEDERAL ST |
| Street Address 2 Of The Provider | 2ND FLOOR |
| City Of The Provider | PITTSBURGH |
| Zip Code Of The Provider | 152124769 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 185 |
| Number Of Medicare Beneficiaries | 154 |
| Total Submitted Charge Amount | 188745 |
| Total Medicare Allowed Amount | 20881.6 |
| Total Medicare Payment Amount | 15497.92 |
| Total Medicare Standardized Payment Amount | 18638.57 |
| 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 | 17 |
| Number Of Medical Services | 185 |
| Number Of Medicare Beneficiaries With Medical Services | 154 |
| Total Medical Submitted Charge Amount | 188745 |
| Total Medical Medicare Allowed Amount | 20881.6 |
| Total Medical Medicare Payment Amount | 15497.92 |
| Total Medical Medicare Standardized Payment Amount | 18638.57 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 33 |
| Number Of Beneficiaries Age 75 to 84 | 21 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 82 |
| Number Of Male Beneficiaries | 72 |
| Number Of Non Hispanic White Beneficiaries | 143 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 78 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.7447 |