| National Provider Identifier [NPI]: | 1164518908 |
| Last Name Of The Provider | JONES |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 777 HOSPITAL WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | POCATELLO |
| Zip Code Of The Provider | 832015175 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 1313 |
| Number Of Medicare Beneficiaries | 279 |
| Total Submitted Charge Amount | 388042.72 |
| Total Medicare Allowed Amount | 129300.1 |
| Total Medicare Payment Amount | 96911.28 |
| Total Medicare Standardized Payment Amount | 104301.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 70 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 18224 |
| Total Drug Medicare AllowedAmount | 7506.01 |
| Total Drug Medicare PaymentAmount | 5866.3 |
| Total Drug Medicare Standardized Payment Amount | 5866.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 1243 |
| Number Of Medicare Beneficiaries With Medical Services | 279 |
| Total Medical Submitted Charge Amount | 369818.72 |
| Total Medical Medicare Allowed Amount | 121794.09 |
| Total Medical Medicare Payment Amount | 91044.98 |
| Total Medical Medicare Standardized Payment Amount | 98434.91 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 116 |
| Number Of Beneficiaries Age 75 to 84 | 95 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 98 |
| Number Of Male Beneficiaries | 181 |
| Number Of Non Hispanic White Beneficiaries | 266 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 219 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 60 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3862 |