| National Provider Identifier [NPI]: | 1174579874 |
| Last Name Of The Provider | PETERSON |
| First Name Of The Provider | DARRYL |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7855 HOWELL BLVD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | BATON ROUGE |
| Zip Code Of The Provider | 708075239 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 165 |
| Number Of Services | 775 |
| Number Of Medicare Beneficiaries | 170 |
| Total Submitted Charge Amount | 321207.7 |
| Total Medicare Allowed Amount | 130385.05 |
| Total Medicare Payment Amount | 98492.88 |
| Total Medicare Standardized Payment Amount | 101763.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 38 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 170.7 |
| Total Drug Medicare AllowedAmount | 100.84 |
| Total Drug Medicare PaymentAmount | 79.03 |
| Total Drug Medicare Standardized Payment Amount | 79.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 160 |
| Number Of Medical Services | 737 |
| Number Of Medicare Beneficiaries With Medical Services | 170 |
| Total Medical Submitted Charge Amount | 321037 |
| Total Medical Medicare Allowed Amount | 130284.21 |
| Total Medical Medicare Payment Amount | 98413.85 |
| Total Medical Medicare Standardized Payment Amount | 101684.68 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 81 |
| Number Of Beneficiaries Age 75 to 84 | 48 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 108 |
| Number Of Male Beneficiaries | 62 |
| Number Of Non Hispanic White Beneficiaries | 158 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 154 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2727 |