| National Provider Identifier [NPI]: | 1528135704 |
| Last Name Of The Provider | LEE |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 34 UPPER RIVERDALE RD SE |
| Street Address 2 Of The Provider | SUITE 100A |
| City Of The Provider | RIVERDALE |
| Zip Code Of The Provider | 302742635 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 2557 |
| Number Of Medicare Beneficiaries | 655 |
| Total Submitted Charge Amount | 740872.96 |
| Total Medicare Allowed Amount | 234574.95 |
| Total Medicare Payment Amount | 157694.78 |
| Total Medicare Standardized Payment Amount | 165181.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 102 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 7540 |
| Total Drug Medicare AllowedAmount | 732.82 |
| Total Drug Medicare PaymentAmount | 700.78 |
| Total Drug Medicare Standardized Payment Amount | 700.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 2455 |
| Number Of Medicare Beneficiaries With Medical Services | 655 |
| Total Medical Submitted Charge Amount | 733332.96 |
| Total Medical Medicare Allowed Amount | 233842.13 |
| Total Medical Medicare Payment Amount | 156994 |
| Total Medical Medicare Standardized Payment Amount | 164480.86 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 225 |
| Number Of Beneficiaries Age 65 to 74 | 235 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 75 |
| Number Of Female Beneficiaries | 400 |
| Number Of Male Beneficiaries | 255 |
| Number Of Non Hispanic White Beneficiaries | 200 |
| Number Of Black or African American Beneficiaries | 363 |
| Number Of AsianPacific Islander Beneficiaries | 61 |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 327 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 328 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4247 |