| National Provider Identifier [NPI]: | 1841291333 |
| Last Name Of The Provider | PETTY |
| First Name Of The Provider | FRED |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5231 BRITTANY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BATON ROUGE |
| Zip Code Of The Provider | 708089143 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 11264 |
| Number Of Medicare Beneficiaries | 2527 |
| Total Submitted Charge Amount | 923648.34 |
| Total Medicare Allowed Amount | 319118.63 |
| Total Medicare Payment Amount | 239441.38 |
| Total Medicare Standardized Payment Amount | 258797.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 6480 |
| Number Of Medicare Beneficiaries With Drug Services | 81 |
| Total Drug Submitted ChargeAmount | 21508 |
| Total Drug Medicare AllowedAmount | 6436.16 |
| Total Drug Medicare PaymentAmount | 5010.36 |
| Total Drug Medicare Standardized Payment Amount | 5010.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 4784 |
| Number Of Medicare Beneficiaries With Medical Services | 2527 |
| Total Medical Submitted Charge Amount | 902140.34 |
| Total Medical Medicare Allowed Amount | 312682.47 |
| Total Medical Medicare Payment Amount | 234431.02 |
| Total Medical Medicare Standardized Payment Amount | 253786.8 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 629 |
| Number Of Beneficiaries Age 65 to 74 | 837 |
| Number Of Beneficiaries Age 75 to 84 | 644 |
| Number Of Beneficiaries Age Greater 84 | 417 |
| Number Of Female Beneficiaries | 1383 |
| Number Of Male Beneficiaries | 1144 |
| Number Of Non Hispanic White Beneficiaries | 1477 |
| Number Of Black or African American Beneficiaries | 979 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1504 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1023 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.2051 |