| National Provider Identifier [NPI]: | 1366468951 |
| Last Name Of The Provider | PEKALA |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 130 FISHER RD |
| Street Address 2 Of The Provider | CVMC |
| City Of The Provider | BERLIN |
| Zip Code Of The Provider | 056029516 |
| State Code Of The Provider | VT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 155 |
| Number Of Services | 5650 |
| Number Of Medicare Beneficiaries | 3044 |
| Total Submitted Charge Amount | 1140926 |
| Total Medicare Allowed Amount | 167471.34 |
| Total Medicare Payment Amount | 138232.07 |
| Total Medicare Standardized Payment Amount | 140768.84 |
| 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 | 155 |
| Number Of Medical Services | 5650 |
| Number Of Medicare Beneficiaries With Medical Services | 3044 |
| Total Medical Submitted Charge Amount | 1140926 |
| Total Medical Medicare Allowed Amount | 167471.34 |
| Total Medical Medicare Payment Amount | 138232.07 |
| Total Medical Medicare Standardized Payment Amount | 140768.84 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 541 |
| Number Of Beneficiaries Age 65 to 74 | 1315 |
| Number Of Beneficiaries Age 75 to 84 | 800 |
| Number Of Beneficiaries Age Greater 84 | 388 |
| Number Of Female Beneficiaries | 2142 |
| Number Of Male Beneficiaries | 902 |
| Number Of Non Hispanic White Beneficiaries | 2935 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 61 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2183 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 861 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0565 |