| National Provider Identifier [NPI]: | 1669449534 |
| Last Name Of The Provider | BOTCHAN |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 66X CONCORD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WILMINGTON |
| Zip Code Of The Provider | 018872127 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 1898 |
| Number Of Medicare Beneficiaries | 209 |
| Total Submitted Charge Amount | 195620.8 |
| Total Medicare Allowed Amount | 83942.81 |
| Total Medicare Payment Amount | 61138.74 |
| Total Medicare Standardized Payment Amount | 57471.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 127 |
| Number Of Medicare Beneficiaries With Drug Services | 78 |
| Total Drug Submitted ChargeAmount | 9099.8 |
| Total Drug Medicare AllowedAmount | 5521.09 |
| Total Drug Medicare PaymentAmount | 5394.92 |
| Total Drug Medicare Standardized Payment Amount | 5394.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 1771 |
| Number Of Medicare Beneficiaries With Medical Services | 209 |
| Total Medical Submitted Charge Amount | 186521 |
| Total Medical Medicare Allowed Amount | 78421.72 |
| Total Medical Medicare Payment Amount | 55743.82 |
| Total Medical Medicare Standardized Payment Amount | 52076.97 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 103 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 86 |
| Number Of Male Beneficiaries | 123 |
| Number Of Non Hispanic White Beneficiaries | 196 |
| 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 | 190 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0028 |