| National Provider Identifier [NPI]: | 1457317349 |
| Last Name Of The Provider | GAZZOLA |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1901 OLD MINNESOTA AVE |
| Street Address 2 Of The Provider | MANKATO CLINIC AT DANIELS HEALTH CENTER |
| City Of The Provider | ST PETER |
| Zip Code Of The Provider | 56082 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 106 |
| Number Of Services | 2058 |
| Number Of Medicare Beneficiaries | 185 |
| Total Submitted Charge Amount | 177537.55 |
| Total Medicare Allowed Amount | 67211.71 |
| Total Medicare Payment Amount | 50555.52 |
| Total Medicare Standardized Payment Amount | 51471.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 336 |
| Number Of Medicare Beneficiaries With Drug Services | 76 |
| Total Drug Submitted ChargeAmount | 9219.55 |
| Total Drug Medicare AllowedAmount | 5016.38 |
| Total Drug Medicare PaymentAmount | 4162.07 |
| Total Drug Medicare Standardized Payment Amount | 4162.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 1722 |
| Number Of Medicare Beneficiaries With Medical Services | 185 |
| Total Medical Submitted Charge Amount | 168318 |
| Total Medical Medicare Allowed Amount | 62195.33 |
| Total Medical Medicare Payment Amount | 46393.45 |
| Total Medical Medicare Standardized Payment Amount | 47309.24 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 61 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 80 |
| Number Of Male Beneficiaries | 105 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 141 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0416 |