| National Provider Identifier [NPI]: | 1669444147 |
| Last Name Of The Provider | KLEIN |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6 MEDICAL DR |
| Street Address 2 Of The Provider | SUITE D |
| City Of The Provider | PORT JEFFERSON STATION |
| Zip Code Of The Provider | 117761594 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 5959 |
| Number Of Medicare Beneficiaries | 1337 |
| Total Submitted Charge Amount | 840006 |
| Total Medicare Allowed Amount | 469818.1 |
| Total Medicare Payment Amount | 350867.66 |
| Total Medicare Standardized Payment Amount | 300802.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 122 |
| Number Of Medicare Beneficiaries With Drug Services | 58 |
| Total Drug Submitted ChargeAmount | 31740 |
| Total Drug Medicare AllowedAmount | 25788.99 |
| Total Drug Medicare PaymentAmount | 20061.67 |
| Total Drug Medicare Standardized Payment Amount | 20061.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 5837 |
| Number Of Medicare Beneficiaries With Medical Services | 1337 |
| Total Medical Submitted Charge Amount | 808266 |
| Total Medical Medicare Allowed Amount | 444029.11 |
| Total Medical Medicare Payment Amount | 330805.99 |
| Total Medical Medicare Standardized Payment Amount | 280741.12 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 100 |
| Number Of Beneficiaries Age 65 to 74 | 653 |
| Number Of Beneficiaries Age 75 to 84 | 401 |
| Number Of Beneficiaries Age Greater 84 | 183 |
| Number Of Female Beneficiaries | 674 |
| Number Of Male Beneficiaries | 663 |
| Number Of Non Hispanic White Beneficiaries | 1259 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1279 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0667 |