| National Provider Identifier [NPI]: | 1770570186 |
| Last Name Of The Provider | PANTELIDIS |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 407 MAIN ST |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | BELPRE |
| Zip Code Of The Provider | 457141615 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 8815 |
| Number Of Medicare Beneficiaries | 635 |
| Total Submitted Charge Amount | 1442621.42 |
| Total Medicare Allowed Amount | 406470.2 |
| Total Medicare Payment Amount | 300530.25 |
| Total Medicare Standardized Payment Amount | 304047.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 5454 |
| Number Of Medicare Beneficiaries With Drug Services | 322 |
| Total Drug Submitted ChargeAmount | 41772.25 |
| Total Drug Medicare AllowedAmount | 13914.98 |
| Total Drug Medicare PaymentAmount | 10514.03 |
| Total Drug Medicare Standardized Payment Amount | 10514.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 3361 |
| Number Of Medicare Beneficiaries With Medical Services | 635 |
| Total Medical Submitted Charge Amount | 1400849.17 |
| Total Medical Medicare Allowed Amount | 392555.22 |
| Total Medical Medicare Payment Amount | 290016.22 |
| Total Medical Medicare Standardized Payment Amount | 293533.42 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 242 |
| Number Of Beneficiaries Age 65 to 74 | 188 |
| Number Of Beneficiaries Age 75 to 84 | 141 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 396 |
| Number Of Male Beneficiaries | 239 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 424 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 211 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2639 |