| National Provider Identifier [NPI]: | 1164433413 |
| Last Name Of The Provider | GHISELLI |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3301 C ST |
| Street Address 2 Of The Provider | SUITE #200-E |
| City Of The Provider | SACRAMENTO |
| Zip Code Of The Provider | 958163300 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 3535 |
| Number Of Medicare Beneficiaries | 2081 |
| Total Submitted Charge Amount | 603779.25 |
| Total Medicare Allowed Amount | 248020.64 |
| Total Medicare Payment Amount | 190088.59 |
| Total Medicare Standardized Payment Amount | 140018.26 |
| 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 | 14 |
| Number Of Medical Services | 3535 |
| Number Of Medicare Beneficiaries With Medical Services | 2081 |
| Total Medical Submitted Charge Amount | 603779.25 |
| Total Medical Medicare Allowed Amount | 248020.64 |
| Total Medical Medicare Payment Amount | 190088.59 |
| Total Medical Medicare Standardized Payment Amount | 140018.26 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 182 |
| Number Of Beneficiaries Age 65 to 74 | 913 |
| Number Of Beneficiaries Age 75 to 84 | 657 |
| Number Of Beneficiaries Age Greater 84 | 329 |
| Number Of Female Beneficiaries | 1015 |
| Number Of Male Beneficiaries | 1066 |
| Number Of Non Hispanic White Beneficiaries | 1854 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 57 |
| Number Of Hispanic Beneficiaries | 99 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1810 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 271 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0358 |