| National Provider Identifier [NPI]: | 1023223021 |
| Last Name Of The Provider | PEACOCK |
| First Name Of The Provider | DENNIS |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4605 MAGAZINE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW ORLEANS |
| Zip Code Of The Provider | 701151517 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 513 |
| Number Of Medicare Beneficiaries | 166 |
| Total Submitted Charge Amount | 49480 |
| Total Medicare Allowed Amount | 24491.17 |
| Total Medicare Payment Amount | 15099.19 |
| Total Medicare Standardized Payment Amount | 16267.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 133 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 980 |
| Total Drug Medicare AllowedAmount | 668.42 |
| Total Drug Medicare PaymentAmount | 470.54 |
| Total Drug Medicare Standardized Payment Amount | 470.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 380 |
| Number Of Medicare Beneficiaries With Medical Services | 166 |
| Total Medical Submitted Charge Amount | 48500 |
| Total Medical Medicare Allowed Amount | 23822.75 |
| Total Medical Medicare Payment Amount | 14628.65 |
| Total Medical Medicare Standardized Payment Amount | 15796.84 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 93 |
| Number Of Beneficiaries Age 75 to 84 | 40 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 113 |
| Number Of Male Beneficiaries | 53 |
| Number Of Non Hispanic White Beneficiaries | 131 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 155 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7613 |