| National Provider Identifier [NPI]: | 1427011634 |
| Last Name Of The Provider | PETERS |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4194 LEXINGTON AVE N |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHOREVIEW |
| Zip Code Of The Provider | 551266106 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 1624 |
| Number Of Medicare Beneficiaries | 207 |
| Total Submitted Charge Amount | 128635 |
| Total Medicare Allowed Amount | 53527.94 |
| Total Medicare Payment Amount | 41258.02 |
| Total Medicare Standardized Payment Amount | 42333.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 77 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 7910 |
| Total Drug Medicare AllowedAmount | 3994.49 |
| Total Drug Medicare PaymentAmount | 3906.03 |
| Total Drug Medicare Standardized Payment Amount | 3906.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 1547 |
| Number Of Medicare Beneficiaries With Medical Services | 207 |
| Total Medical Submitted Charge Amount | 120725 |
| Total Medical Medicare Allowed Amount | 49533.45 |
| Total Medical Medicare Payment Amount | 37351.99 |
| Total Medical Medicare Standardized Payment Amount | 38427.29 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 63 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 101 |
| Number Of Male Beneficiaries | 106 |
| Number Of Non Hispanic White Beneficiaries | 194 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 181 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.232 |