| National Provider Identifier [NPI]: | 1689757635 |
| Last Name Of The Provider | PESSOA |
| First Name Of The Provider | CORNELIA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2320 WOOLSEY ST |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | BERKELEY |
| Zip Code Of The Provider | 947051973 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 6220 |
| Number Of Medicare Beneficiaries | 822 |
| Total Submitted Charge Amount | 393084.96 |
| Total Medicare Allowed Amount | 364721.71 |
| Total Medicare Payment Amount | 264985.56 |
| Total Medicare Standardized Payment Amount | 228485.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 95 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 9332.7 |
| Total Drug Medicare AllowedAmount | 9238.74 |
| Total Drug Medicare PaymentAmount | 7238.72 |
| Total Drug Medicare Standardized Payment Amount | 7238.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 6125 |
| Number Of Medicare Beneficiaries With Medical Services | 822 |
| Total Medical Submitted Charge Amount | 383752.26 |
| Total Medical Medicare Allowed Amount | 355482.97 |
| Total Medical Medicare Payment Amount | 257746.84 |
| Total Medical Medicare Standardized Payment Amount | 221246.61 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 470 |
| Number Of Beneficiaries Age 75 to 84 | 203 |
| Number Of Beneficiaries Age Greater 84 | 122 |
| Number Of Female Beneficiaries | 508 |
| Number Of Male Beneficiaries | 314 |
| Number Of Non Hispanic White Beneficiaries | 762 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 802 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 11 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 35 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8216 |