| National Provider Identifier [NPI]: | 1245211242 |
| Last Name Of The Provider | PETERSON |
| First Name Of The Provider | JOHN |
| 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 | 1201 5TH AVE NORTH |
| Street Address 2 Of The Provider | SUITE 505 |
| City Of The Provider | ST PETERSBURG |
| Zip Code Of The Provider | 337051455 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 184 |
| Number Of Services | 307261 |
| Number Of Medicare Beneficiaries | 902 |
| Total Submitted Charge Amount | 7420557 |
| Total Medicare Allowed Amount | 2830775.73 |
| Total Medicare Payment Amount | 2231254.94 |
| Total Medicare Standardized Payment Amount | 2225497.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 90 |
| Number Of Drug Services | 290318 |
| Number Of Medicare Beneficiaries With Drug Services | 445 |
| Total Drug Submitted ChargeAmount | 5964471 |
| Total Drug Medicare AllowedAmount | 2284847.07 |
| Total Drug Medicare PaymentAmount | 1787711.95 |
| Total Drug Medicare Standardized Payment Amount | 1787711.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 16943 |
| Number Of Medicare Beneficiaries With Medical Services | 902 |
| Total Medical Submitted Charge Amount | 1456086 |
| Total Medical Medicare Allowed Amount | 545928.66 |
| Total Medical Medicare Payment Amount | 443542.99 |
| Total Medical Medicare Standardized Payment Amount | 437785.32 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 95 |
| Number Of Beneficiaries Age 65 to 74 | 312 |
| Number Of Beneficiaries Age 75 to 84 | 302 |
| Number Of Beneficiaries Age Greater 84 | 193 |
| Number Of Female Beneficiaries | 574 |
| Number Of Male Beneficiaries | 328 |
| Number Of Non Hispanic White Beneficiaries | 810 |
| Number Of Black or African American Beneficiaries | 59 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 763 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 139 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 47 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.0185 |