| National Provider Identifier [NPI]: | 1447267505 |
| Last Name Of The Provider | BERTOLUCCI |
| First Name Of The Provider | GEORGE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1360 E HERNDON AVENUE |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | FRESNO |
| Zip Code Of The Provider | 937203326 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 18210 |
| Number Of Medicare Beneficiaries | 1620 |
| Total Submitted Charge Amount | 6549928 |
| Total Medicare Allowed Amount | 4220199.09 |
| Total Medicare Payment Amount | 3255845.39 |
| Total Medicare Standardized Payment Amount | 3229892.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 7837 |
| Number Of Medicare Beneficiaries With Drug Services | 333 |
| Total Drug Submitted ChargeAmount | 4121132 |
| Total Drug Medicare AllowedAmount | 3202404.76 |
| Total Drug Medicare PaymentAmount | 2496289.85 |
| Total Drug Medicare Standardized Payment Amount | 2496289.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 10373 |
| Number Of Medicare Beneficiaries With Medical Services | 1620 |
| Total Medical Submitted Charge Amount | 2428796 |
| Total Medical Medicare Allowed Amount | 1017794.33 |
| Total Medical Medicare Payment Amount | 759555.54 |
| Total Medical Medicare Standardized Payment Amount | 733602.81 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 95 |
| Number Of Beneficiaries Age 65 to 74 | 530 |
| Number Of Beneficiaries Age 75 to 84 | 547 |
| Number Of Beneficiaries Age Greater 84 | 448 |
| Number Of Female Beneficiaries | 986 |
| Number Of Male Beneficiaries | 634 |
| Number Of Non Hispanic White Beneficiaries | 1268 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 53 |
| Number Of Hispanic Beneficiaries | 237 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1350 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 270 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3698 |