National Provider Identifier [NPI]: |
1073575379 |
Last Name Of The Provider |
PETERSON |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2000 MEDICAL PARKWAY |
Street Address 2 Of The Provider |
SUITE 607 |
City Of The Provider |
ANNAPOLIS |
Zip Code Of The Provider |
214011001 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
1867 |
Number Of Medicare Beneficiaries |
684 |
Total Submitted Charge Amount |
338352 |
Total Medicare Allowed Amount |
211895.79 |
Total Medicare Payment Amount |
158700.46 |
Total Medicare Standardized Payment Amount |
151840.43 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
76 |
Number Of Beneficiaries Age 65 to 74 |
259 |
Number Of Beneficiaries Age 75 to 84 |
241 |
Number Of Beneficiaries Age Greater 84 |
108 |
Number Of Female Beneficiaries |
388 |
Number Of Male Beneficiaries |
296 |
Number Of Non Hispanic White Beneficiaries |
553 |
Number Of Black or African American Beneficiaries |
118 |
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 |
610 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
51 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.1866 |