| National Provider Identifier [NPI]: | 1790767317 |
| Last Name Of The Provider | PAVELA |
| First Name Of The Provider | STEPHEN |
| 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 | 800 WEST AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | LA CROSSE |
| Zip Code Of The Provider | 546018806 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 3261 |
| Number Of Medicare Beneficiaries | 1159 |
| Total Submitted Charge Amount | 389473.19 |
| Total Medicare Allowed Amount | 155900.94 |
| Total Medicare Payment Amount | 113050.84 |
| Total Medicare Standardized Payment Amount | 117129.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 432 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 9715.53 |
| Total Drug Medicare AllowedAmount | 3922.14 |
| Total Drug Medicare PaymentAmount | 3138.38 |
| Total Drug Medicare Standardized Payment Amount | 3138.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 2829 |
| Number Of Medicare Beneficiaries With Medical Services | 1159 |
| Total Medical Submitted Charge Amount | 379757.66 |
| Total Medical Medicare Allowed Amount | 151978.8 |
| Total Medical Medicare Payment Amount | 109912.46 |
| Total Medical Medicare Standardized Payment Amount | 113991.47 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 173 |
| Number Of Beneficiaries Age 65 to 74 | 382 |
| Number Of Beneficiaries Age 75 to 84 | 330 |
| Number Of Beneficiaries Age Greater 84 | 274 |
| Number Of Female Beneficiaries | 651 |
| Number Of Male Beneficiaries | 508 |
| Number Of Non Hispanic White Beneficiaries | 1124 |
| 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 | 833 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 326 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3607 |