| National Provider Identifier [NPI]: | 1740243674 |
| Last Name Of The Provider | PELLER |
| First Name Of The Provider | PAUL |
| 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 | 4230 HEMPSTEAD TPKE |
| Street Address 2 Of The Provider | |
| City Of The Provider | BETHPAGE |
| Zip Code Of The Provider | 117145700 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 7115 |
| Number Of Medicare Beneficiaries | 705 |
| Total Submitted Charge Amount | 1280557.46 |
| Total Medicare Allowed Amount | 353709.2 |
| Total Medicare Payment Amount | 264686.39 |
| Total Medicare Standardized Payment Amount | 235640.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1781 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 156539.31 |
| Total Drug Medicare AllowedAmount | 54693.56 |
| Total Drug Medicare PaymentAmount | 40930.95 |
| Total Drug Medicare Standardized Payment Amount | 40930.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 5334 |
| Number Of Medicare Beneficiaries With Medical Services | 705 |
| Total Medical Submitted Charge Amount | 1124018.15 |
| Total Medical Medicare Allowed Amount | 299015.64 |
| Total Medical Medicare Payment Amount | 223755.44 |
| Total Medical Medicare Standardized Payment Amount | 194709.97 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 285 |
| Number Of Beneficiaries Age 75 to 84 | 231 |
| Number Of Beneficiaries Age Greater 84 | 123 |
| Number Of Female Beneficiaries | 256 |
| Number Of Male Beneficiaries | 449 |
| Number Of Non Hispanic White Beneficiaries | 662 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 633 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 72 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4259 |