| National Provider Identifier [NPI]: | 1285662015 |
| Last Name Of The Provider | PESOLA |
| First Name Of The Provider | DAVID |
| 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 | 1414 WEST FAIR AVENUE |
| Street Address 2 Of The Provider | SUITE 334 |
| City Of The Provider | MARQUETTE |
| Zip Code Of The Provider | 49855 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 5456 |
| Number Of Medicare Beneficiaries | 1621 |
| Total Submitted Charge Amount | 1874294.51 |
| Total Medicare Allowed Amount | 371886.33 |
| Total Medicare Payment Amount | 276620.3 |
| Total Medicare Standardized Payment Amount | 286514.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 70 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 14000 |
| Total Drug Medicare AllowedAmount | 3895.08 |
| Total Drug Medicare PaymentAmount | 3053.81 |
| Total Drug Medicare Standardized Payment Amount | 3053.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 5386 |
| Number Of Medicare Beneficiaries With Medical Services | 1621 |
| Total Medical Submitted Charge Amount | 1860294.51 |
| Total Medical Medicare Allowed Amount | 367991.25 |
| Total Medical Medicare Payment Amount | 273566.49 |
| Total Medical Medicare Standardized Payment Amount | 283460.27 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 189 |
| Number Of Beneficiaries Age 65 to 74 | 557 |
| Number Of Beneficiaries Age 75 to 84 | 544 |
| Number Of Beneficiaries Age Greater 84 | 331 |
| Number Of Female Beneficiaries | 766 |
| Number Of Male Beneficiaries | 855 |
| Number Of Non Hispanic White Beneficiaries | 1547 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 46 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1263 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 358 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5429 |