| National Provider Identifier [NPI]: | 1639157936 |
| Last Name Of The Provider | FERGUS |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1727 SHAWANO AVE |
| Street Address 2 Of The Provider | STE 201 |
| City Of The Provider | GREEN BAY |
| Zip Code Of The Provider | 543033273 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 5810 |
| Number Of Medicare Beneficiaries | 991 |
| Total Submitted Charge Amount | 1229988.25 |
| Total Medicare Allowed Amount | 220035.53 |
| Total Medicare Payment Amount | 161273.96 |
| Total Medicare Standardized Payment Amount | 167723.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 87 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 33699 |
| Total Drug Medicare AllowedAmount | 4042.45 |
| Total Drug Medicare PaymentAmount | 3213.87 |
| Total Drug Medicare Standardized Payment Amount | 3213.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 5723 |
| Number Of Medicare Beneficiaries With Medical Services | 991 |
| Total Medical Submitted Charge Amount | 1196289.25 |
| Total Medical Medicare Allowed Amount | 215993.08 |
| Total Medical Medicare Payment Amount | 158060.09 |
| Total Medical Medicare Standardized Payment Amount | 164510.03 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 322 |
| Number Of Beneficiaries Age 75 to 84 | 373 |
| Number Of Beneficiaries Age Greater 84 | 247 |
| Number Of Female Beneficiaries | 470 |
| Number Of Male Beneficiaries | 521 |
| Number Of Non Hispanic White Beneficiaries | 954 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 25 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 871 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 120 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2957 |