| National Provider Identifier [NPI]: | 1891703021 |
| Last Name Of The Provider | PETERS |
| First Name Of The Provider | GERALD |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2600 NE NEFF RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEND |
| Zip Code Of The Provider | 977016337 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 6632 |
| Number Of Medicare Beneficiaries | 930 |
| Total Submitted Charge Amount | 2952071.61 |
| Total Medicare Allowed Amount | 852806.06 |
| Total Medicare Payment Amount | 649415.95 |
| Total Medicare Standardized Payment Amount | 653232.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 90 |
| Number Of Medicare Beneficiaries With Drug Services | 70 |
| Total Drug Submitted ChargeAmount | 28081.05 |
| Total Drug Medicare AllowedAmount | 21398.29 |
| Total Drug Medicare PaymentAmount | 15423.06 |
| Total Drug Medicare Standardized Payment Amount | 15423.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 6542 |
| Number Of Medicare Beneficiaries With Medical Services | 930 |
| Total Medical Submitted Charge Amount | 2923990.56 |
| Total Medical Medicare Allowed Amount | 831407.77 |
| Total Medical Medicare Payment Amount | 633992.89 |
| Total Medical Medicare Standardized Payment Amount | 637809.86 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 464 |
| Number Of Beneficiaries Age 75 to 84 | 305 |
| Number Of Beneficiaries Age Greater 84 | 127 |
| Number Of Female Beneficiaries | 411 |
| Number Of Male Beneficiaries | 519 |
| Number Of Non Hispanic White Beneficiaries | 906 |
| Number Of Black or African American Beneficiaries | |
| 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 | 890 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9493 |