Over 22 million cases of wine are produced each year in Abruzzo, making it the seventh most productive region in Italy, but only 21.5% is produced under the denomination Denomination of Controlled Origin (DOC). Over two-thirds of the region's wine is produced by cooperatives or sold in bulk to retailers in other Italian wine regions such as Tuscany, Piedmont and Veneto for blending. The most important wine of the region is the Montepulciano d'Abruzzo, produced with the Montepulciano grape, which differs from the Sangiovese grapes behind the Tuscan wine Nobile di Montepulciano. Together with Trebbiano d'Abruzzo, Montepulciano d'Abruzzo is one of the most exported DOC wines from Italy, particularly in the United States. While wine is produced in all four provinces of Abruzzo, most of the production takes place in the province of Chieti, which is the fifth province for production in all of Italy. Some of the most appreciated wines of Abruzzo come from the hillside vineyards of the northern provinces of Pescara and Teramo. In the completely mountainous province of L'Aquila in the west, rosé wine known as Cerasuolo from the Montepulciano grape is produced.