| National Provider Identifier [NPI]: | 1770543993 |
| Last Name Of The Provider | PACER |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5015 N. ROYAL DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TRAVERSE CITY |
| Zip Code Of The Provider | 49684 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 5677.5 |
| Number Of Medicare Beneficiaries | 231 |
| Total Submitted Charge Amount | 250584.12 |
| Total Medicare Allowed Amount | 123684.57 |
| Total Medicare Payment Amount | 99339.73 |
| Total Medicare Standardized Payment Amount | 103582.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 302.5 |
| Number Of Medicare Beneficiaries With Drug Services | 165 |
| Total Drug Submitted ChargeAmount | 7923.5 |
| Total Drug Medicare AllowedAmount | 5604.45 |
| Total Drug Medicare PaymentAmount | 5317.74 |
| Total Drug Medicare Standardized Payment Amount | 5317.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 5375 |
| Number Of Medicare Beneficiaries With Medical Services | 231 |
| Total Medical Submitted Charge Amount | 242660.62 |
| Total Medical Medicare Allowed Amount | 118080.12 |
| Total Medical Medicare Payment Amount | 94021.99 |
| Total Medical Medicare Standardized Payment Amount | 98264.6 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 111 |
| Number Of Beneficiaries Age 75 to 84 | 75 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 101 |
| Number Of Male Beneficiaries | 130 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1506 |