| National Provider Identifier [NPI]: | 1700882818 |
| Last Name Of The Provider | KOURLAS |
| 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 | 810 JASONWAY AVE |
| Street Address 2 Of The Provider | STE A |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432144359 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 57586 |
| Number Of Medicare Beneficiaries | 302 |
| Total Submitted Charge Amount | 2605802 |
| Total Medicare Allowed Amount | 823600.03 |
| Total Medicare Payment Amount | 627567.27 |
| Total Medicare Standardized Payment Amount | 631653.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 46 |
| Number Of Drug Services | 55563 |
| Number Of Medicare Beneficiaries With Drug Services | 65 |
| Total Drug Submitted ChargeAmount | 2001961 |
| Total Drug Medicare AllowedAmount | 667316.51 |
| Total Drug Medicare PaymentAmount | 510562.35 |
| Total Drug Medicare Standardized Payment Amount | 510562.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 2023 |
| Number Of Medicare Beneficiaries With Medical Services | 302 |
| Total Medical Submitted Charge Amount | 603841 |
| Total Medical Medicare Allowed Amount | 156283.52 |
| Total Medical Medicare Payment Amount | 117004.92 |
| Total Medical Medicare Standardized Payment Amount | 121090.88 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 125 |
| Number Of Beneficiaries Age 75 to 84 | 91 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 170 |
| Number Of Male Beneficiaries | 132 |
| Number Of Non Hispanic White Beneficiaries | 276 |
| 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 | 267 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 47 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.8121 |