| National Provider Identifier [NPI]: | 1992712483 |
| Last Name Of The Provider | GIMINO |
| First Name Of The Provider | VINCENT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3680 NW SAMARITAN DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CORVALLIS |
| Zip Code Of The Provider | 973303737 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 1467 |
| Number Of Medicare Beneficiaries | 494 |
| Total Submitted Charge Amount | 341826 |
| Total Medicare Allowed Amount | 94296.93 |
| Total Medicare Payment Amount | 72161.96 |
| Total Medicare Standardized Payment Amount | 70677.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 232 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 1037 |
| Total Drug Medicare AllowedAmount | 607.63 |
| Total Drug Medicare PaymentAmount | 579.47 |
| Total Drug Medicare Standardized Payment Amount | 579.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 1235 |
| Number Of Medicare Beneficiaries With Medical Services | 494 |
| Total Medical Submitted Charge Amount | 340789 |
| Total Medical Medicare Allowed Amount | 93689.3 |
| Total Medical Medicare Payment Amount | 71582.49 |
| Total Medical Medicare Standardized Payment Amount | 70098.52 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 97 |
| Number Of Beneficiaries Age 65 to 74 | 232 |
| Number Of Beneficiaries Age 75 to 84 | 125 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 259 |
| Number Of Male Beneficiaries | 235 |
| Number Of Non Hispanic White Beneficiaries | 471 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 386 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 108 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4424 |