| National Provider Identifier [NPI]: | 1265400592 |
| Last Name Of The Provider | GERVASI |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6900 PEARL ROAD |
| Street Address 2 Of The Provider | 2ND FLOOR |
| City Of The Provider | MIDDLEBURG HEIGHTS |
| Zip Code Of The Provider | 44130 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 14620 |
| Number Of Medicare Beneficiaries | 1016 |
| Total Submitted Charge Amount | 1255684.04 |
| Total Medicare Allowed Amount | 445488.44 |
| Total Medicare Payment Amount | 332717.65 |
| Total Medicare Standardized Payment Amount | 342365.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 10639 |
| Number Of Medicare Beneficiaries With Drug Services | 70 |
| Total Drug Submitted ChargeAmount | 296321.1 |
| Total Drug Medicare AllowedAmount | 168317.24 |
| Total Drug Medicare PaymentAmount | 129684.63 |
| Total Drug Medicare Standardized Payment Amount | 129684.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 90 |
| Number Of Medical Services | 3981 |
| Number Of Medicare Beneficiaries With Medical Services | 1016 |
| Total Medical Submitted Charge Amount | 959362.94 |
| Total Medical Medicare Allowed Amount | 277171.2 |
| Total Medical Medicare Payment Amount | 203033.02 |
| Total Medical Medicare Standardized Payment Amount | 212680.47 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 76 |
| Number Of Beneficiaries Age 65 to 74 | 363 |
| Number Of Beneficiaries Age 75 to 84 | 367 |
| Number Of Beneficiaries Age Greater 84 | 210 |
| Number Of Female Beneficiaries | 240 |
| Number Of Male Beneficiaries | 776 |
| Number Of Non Hispanic White Beneficiaries | 965 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 899 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 117 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4808 |