| National Provider Identifier [NPI]: | 1871541524 |
| Last Name Of The Provider | PESTANER |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2025 SOQUEL AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANTA CRUZ |
| Zip Code Of The Provider | 950621323 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 199 |
| Number Of Services | 40702 |
| Number Of Medicare Beneficiaries | 3325 |
| Total Submitted Charge Amount | 2859878 |
| Total Medicare Allowed Amount | 568116.14 |
| Total Medicare Payment Amount | 428262.5 |
| Total Medicare Standardized Payment Amount | 404164.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 35363 |
| Number Of Medicare Beneficiaries With Drug Services | 389 |
| Total Drug Submitted ChargeAmount | 45364 |
| Total Drug Medicare AllowedAmount | 9094.89 |
| Total Drug Medicare PaymentAmount | 7124.07 |
| Total Drug Medicare Standardized Payment Amount | 7124.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 193 |
| Number Of Medical Services | 5339 |
| Number Of Medicare Beneficiaries With Medical Services | 3324 |
| Total Medical Submitted Charge Amount | 2814514 |
| Total Medical Medicare Allowed Amount | 559021.25 |
| Total Medical Medicare Payment Amount | 421138.43 |
| Total Medical Medicare Standardized Payment Amount | 397040.26 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 327 |
| Number Of Beneficiaries Age 65 to 74 | 1615 |
| Number Of Beneficiaries Age 75 to 84 | 904 |
| Number Of Beneficiaries Age Greater 84 | 479 |
| Number Of Female Beneficiaries | 2074 |
| Number Of Male Beneficiaries | 1251 |
| Number Of Non Hispanic White Beneficiaries | 2888 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 55 |
| Number Of Hispanic Beneficiaries | 292 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 65 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2859 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 466 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0811 |