| National Provider Identifier [NPI]: | 1154324093 |
| Last Name Of The Provider | PETERSON |
| First Name Of The Provider | ERIC |
| 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 | 1436 RIVERCHASE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCK HILL |
| Zip Code Of The Provider | 297321777 |
| State Code Of The Provider | SC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 5077 |
| Number Of Medicare Beneficiaries | 765 |
| Total Submitted Charge Amount | 1296346.4 |
| Total Medicare Allowed Amount | 456501.79 |
| Total Medicare Payment Amount | 347523.63 |
| Total Medicare Standardized Payment Amount | 363959.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 2334 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 76186.4 |
| Total Drug Medicare AllowedAmount | 21884.39 |
| Total Drug Medicare PaymentAmount | 17163.33 |
| Total Drug Medicare Standardized Payment Amount | 17163.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 2743 |
| Number Of Medicare Beneficiaries With Medical Services | 765 |
| Total Medical Submitted Charge Amount | 1220160 |
| Total Medical Medicare Allowed Amount | 434617.4 |
| Total Medical Medicare Payment Amount | 330360.3 |
| Total Medical Medicare Standardized Payment Amount | 346796.42 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 217 |
| Number Of Beneficiaries Age 65 to 74 | 265 |
| Number Of Beneficiaries Age 75 to 84 | 204 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 372 |
| Number Of Male Beneficiaries | 393 |
| Number Of Non Hispanic White Beneficiaries | 425 |
| Number Of Black or African American Beneficiaries | 318 |
| 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 | 514 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 251 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 65 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 3.965 |