| National Provider Identifier [NPI]: | 1245282995 |
| Last Name Of The Provider | FORTINO |
| First Name Of The Provider | GREGG |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 210 W ATLANTIC AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HADDON HEIGHTS |
| Zip Code Of The Provider | 080351715 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 7288 |
| Number Of Medicare Beneficiaries | 3501 |
| Total Submitted Charge Amount | 1072525.16 |
| Total Medicare Allowed Amount | 617728.82 |
| Total Medicare Payment Amount | 461214.34 |
| Total Medicare Standardized Payment Amount | 439098.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 460 |
| Number Of Medicare Beneficiaries With Drug Services | 72 |
| Total Drug Submitted ChargeAmount | 14888.16 |
| Total Drug Medicare AllowedAmount | 14853.63 |
| Total Drug Medicare PaymentAmount | 11644.26 |
| Total Drug Medicare Standardized Payment Amount | 11644.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 6828 |
| Number Of Medicare Beneficiaries With Medical Services | 3500 |
| Total Medical Submitted Charge Amount | 1057637 |
| Total Medical Medicare Allowed Amount | 602875.19 |
| Total Medical Medicare Payment Amount | 449570.08 |
| Total Medical Medicare Standardized Payment Amount | 427454.18 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 388 |
| Number Of Beneficiaries Age 65 to 74 | 1190 |
| Number Of Beneficiaries Age 75 to 84 | 1056 |
| Number Of Beneficiaries Age Greater 84 | 867 |
| Number Of Female Beneficiaries | 1925 |
| Number Of Male Beneficiaries | 1576 |
| Number Of Non Hispanic White Beneficiaries | 2853 |
| Number Of Black or African American Beneficiaries | 417 |
| Number Of AsianPacific Islander Beneficiaries | 62 |
| Number Of Hispanic Beneficiaries | 129 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2960 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 541 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 1.9296 |