| National Provider Identifier [NPI]: | 1821203167 |
| Last Name Of The Provider | BLANCO |
| First Name Of The Provider | GEORGE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 560 JACKSON ST N |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | ST PETERSBURG |
| Zip Code Of The Provider | 337051405 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 4239 |
| Number Of Medicare Beneficiaries | 1330 |
| Total Submitted Charge Amount | 1138943 |
| Total Medicare Allowed Amount | 458701.61 |
| Total Medicare Payment Amount | 345077.31 |
| Total Medicare Standardized Payment Amount | 347609.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 369 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 56822 |
| Total Drug Medicare AllowedAmount | 19170.68 |
| Total Drug Medicare PaymentAmount | 14740.12 |
| Total Drug Medicare Standardized Payment Amount | 14740.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 3870 |
| Number Of Medicare Beneficiaries With Medical Services | 1330 |
| Total Medical Submitted Charge Amount | 1082121 |
| Total Medical Medicare Allowed Amount | 439530.93 |
| Total Medical Medicare Payment Amount | 330337.19 |
| Total Medical Medicare Standardized Payment Amount | 332869.85 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 200 |
| Number Of Beneficiaries Age 65 to 74 | 336 |
| Number Of Beneficiaries Age 75 to 84 | 453 |
| Number Of Beneficiaries Age Greater 84 | 341 |
| Number Of Female Beneficiaries | 714 |
| Number Of Male Beneficiaries | 616 |
| Number Of Non Hispanic White Beneficiaries | 1077 |
| Number Of Black or African American Beneficiaries | 198 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 998 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 332 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.2078 |