| National Provider Identifier [NPI]: | 1508814989 |
| Last Name Of The Provider | GOSSELIN |
| First Name Of The Provider | MARC |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 24211 LITTLE MACK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST CLAIR SHORES |
| Zip Code Of The Provider | 480801190 |
| 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 | 65 |
| Number Of Services | 4620 |
| Number Of Medicare Beneficiaries | 1715 |
| Total Submitted Charge Amount | 761310.04 |
| Total Medicare Allowed Amount | 439610.31 |
| Total Medicare Payment Amount | 330632.81 |
| Total Medicare Standardized Payment Amount | 322693.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 4620 |
| Number Of Medicare Beneficiaries With Medical Services | 1715 |
| Total Medical Submitted Charge Amount | 761310.04 |
| Total Medical Medicare Allowed Amount | 439610.31 |
| Total Medical Medicare Payment Amount | 330632.81 |
| Total Medical Medicare Standardized Payment Amount | 322693.73 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 280 |
| Number Of Beneficiaries Age 65 to 74 | 563 |
| Number Of Beneficiaries Age 75 to 84 | 536 |
| Number Of Beneficiaries Age Greater 84 | 336 |
| Number Of Female Beneficiaries | 865 |
| Number Of Male Beneficiaries | 850 |
| Number Of Non Hispanic White Beneficiaries | 1291 |
| Number Of Black or African American Beneficiaries | 381 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1358 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 357 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.1618 |