| National Provider Identifier [NPI]: | 1902812746 |
| Last Name Of The Provider | PESSANHA |
| First Name Of The Provider | BRENO |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 610 N MICHIGAN ST |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | SOUTH BEND |
| Zip Code Of The Provider | 466011077 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 4751 |
| Number Of Medicare Beneficiaries | 1662 |
| Total Submitted Charge Amount | 808012 |
| Total Medicare Allowed Amount | 291024.26 |
| Total Medicare Payment Amount | 214528.94 |
| Total Medicare Standardized Payment Amount | 227040.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 693 |
| Number Of Medicare Beneficiaries With Drug Services | 172 |
| Total Drug Submitted ChargeAmount | 83384 |
| Total Drug Medicare AllowedAmount | 28174.85 |
| Total Drug Medicare PaymentAmount | 21810.76 |
| Total Drug Medicare Standardized Payment Amount | 21810.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 4058 |
| Number Of Medicare Beneficiaries With Medical Services | 1662 |
| Total Medical Submitted Charge Amount | 724628 |
| Total Medical Medicare Allowed Amount | 262849.41 |
| Total Medical Medicare Payment Amount | 192718.18 |
| Total Medical Medicare Standardized Payment Amount | 205229.37 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 185 |
| Number Of Beneficiaries Age 65 to 74 | 623 |
| Number Of Beneficiaries Age 75 to 84 | 575 |
| Number Of Beneficiaries Age Greater 84 | 279 |
| Number Of Female Beneficiaries | 888 |
| Number Of Male Beneficiaries | 774 |
| Number Of Non Hispanic White Beneficiaries | 1479 |
| Number Of Black or African American Beneficiaries | 130 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1395 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 267 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4253 |