| National Provider Identifier [NPI]: | 1932296944 |
| Last Name Of The Provider | STICKNEY |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 69 ALLEN STREET |
| Street Address 2 Of The Provider | SUITE #5 |
| City Of The Provider | RUTLAND |
| Zip Code Of The Provider | 05701 |
| State Code Of The Provider | VT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 4024 |
| Number Of Medicare Beneficiaries | 680 |
| Total Submitted Charge Amount | 427107.5 |
| Total Medicare Allowed Amount | 376169.13 |
| Total Medicare Payment Amount | 260599.2 |
| Total Medicare Standardized Payment Amount | 267917.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 592 |
| Number Of Medicare Beneficiaries With Drug Services | 323 |
| Total Drug Submitted ChargeAmount | 10770 |
| Total Drug Medicare AllowedAmount | 6551.1 |
| Total Drug Medicare PaymentAmount | 6165.2 |
| Total Drug Medicare Standardized Payment Amount | 6165.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 3432 |
| Number Of Medicare Beneficiaries With Medical Services | 680 |
| Total Medical Submitted Charge Amount | 416337.5 |
| Total Medical Medicare Allowed Amount | 369618.03 |
| Total Medical Medicare Payment Amount | 254434 |
| Total Medical Medicare Standardized Payment Amount | 261751.97 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 267 |
| Number Of Beneficiaries Age 75 to 84 | 216 |
| Number Of Beneficiaries Age Greater 84 | 140 |
| Number Of Female Beneficiaries | 387 |
| Number Of Male Beneficiaries | 293 |
| Number Of Non Hispanic White Beneficiaries | 664 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 508 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 172 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3282 |