| National Provider Identifier [NPI]: | 1336196815 |
| Last Name Of The Provider | BLACKBURN |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 65 EAST CITY DAM RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CORBIN |
| Zip Code Of The Provider | 407014620 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 8109 |
| Number Of Medicare Beneficiaries | 1186 |
| Total Submitted Charge Amount | 2338319 |
| Total Medicare Allowed Amount | 886691.46 |
| Total Medicare Payment Amount | 663551.05 |
| Total Medicare Standardized Payment Amount | 703040.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1514 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 504751 |
| Total Drug Medicare AllowedAmount | 281213.86 |
| Total Drug Medicare PaymentAmount | 215305.25 |
| Total Drug Medicare Standardized Payment Amount | 215305.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 6595 |
| Number Of Medicare Beneficiaries With Medical Services | 1185 |
| Total Medical Submitted Charge Amount | 1833568 |
| Total Medical Medicare Allowed Amount | 605477.6 |
| Total Medical Medicare Payment Amount | 448245.8 |
| Total Medical Medicare Standardized Payment Amount | 487734.79 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 183 |
| Number Of Beneficiaries Age 65 to 74 | 432 |
| Number Of Beneficiaries Age 75 to 84 | 384 |
| Number Of Beneficiaries Age Greater 84 | 187 |
| Number Of Female Beneficiaries | 712 |
| Number Of Male Beneficiaries | 474 |
| Number Of Non Hispanic White Beneficiaries | 1124 |
| Number Of Black or African American Beneficiaries | 42 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 841 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 345 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5144 |