| National Provider Identifier [NPI]: | 1992770093 |
| Last Name Of The Provider | PESIN |
| First Name Of The Provider | SAMUEL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2865 N REYNOLDS RD |
| Street Address 2 Of The Provider | SUITE 230 |
| City Of The Provider | TOLEDO |
| Zip Code Of The Provider | 436152068 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 12632 |
| Number Of Medicare Beneficiaries | 720 |
| Total Submitted Charge Amount | 4441616 |
| Total Medicare Allowed Amount | 3077293.26 |
| Total Medicare Payment Amount | 2383875.94 |
| Total Medicare Standardized Payment Amount | 2404560.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 6289 |
| Number Of Medicare Beneficiaries With Drug Services | 238 |
| Total Drug Submitted ChargeAmount | 3503890 |
| Total Drug Medicare AllowedAmount | 2497498.89 |
| Total Drug Medicare PaymentAmount | 1952510.11 |
| Total Drug Medicare Standardized Payment Amount | 1952510.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 6343 |
| Number Of Medicare Beneficiaries With Medical Services | 720 |
| Total Medical Submitted Charge Amount | 937726 |
| Total Medical Medicare Allowed Amount | 579794.37 |
| Total Medical Medicare Payment Amount | 431365.83 |
| Total Medical Medicare Standardized Payment Amount | 452049.93 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 223 |
| Number Of Beneficiaries Age 75 to 84 | 239 |
| Number Of Beneficiaries Age Greater 84 | 195 |
| Number Of Female Beneficiaries | 430 |
| Number Of Male Beneficiaries | 290 |
| Number Of Non Hispanic White Beneficiaries | 681 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 639 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3868 |