| National Provider Identifier [NPI]: | 1407823792 |
| Last Name Of The Provider | PELTIER |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8644 SUDLEY RD |
| Street Address 2 Of The Provider | SUITE 308 |
| City Of The Provider | MANASSAS |
| Zip Code Of The Provider | 201104400 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 2400 |
| Number Of Medicare Beneficiaries | 342 |
| Total Submitted Charge Amount | 360702.78 |
| Total Medicare Allowed Amount | 145112.81 |
| Total Medicare Payment Amount | 106192.09 |
| Total Medicare Standardized Payment Amount | 112863.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 949 |
| Number Of Medicare Beneficiaries With Drug Services | 125 |
| Total Drug Submitted ChargeAmount | 11433 |
| Total Drug Medicare AllowedAmount | 4939.41 |
| Total Drug Medicare PaymentAmount | 3788.39 |
| Total Drug Medicare Standardized Payment Amount | 3788.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 1451 |
| Number Of Medicare Beneficiaries With Medical Services | 342 |
| Total Medical Submitted Charge Amount | 349269.78 |
| Total Medical Medicare Allowed Amount | 140173.4 |
| Total Medical Medicare Payment Amount | 102403.7 |
| Total Medical Medicare Standardized Payment Amount | 109075.36 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 199 |
| Number Of Beneficiaries Age 75 to 84 | 92 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 197 |
| Number Of Male Beneficiaries | 145 |
| Number Of Non Hispanic White Beneficiaries | 308 |
| Number Of Black or African American Beneficiaries | 18 |
| 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 | 316 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9875 |