| National Provider Identifier [NPI]: | 1831522051 |
| Last Name Of The Provider | PETERSON |
| First Name Of The Provider | MICHELLE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | NP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 70 EAST ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | METHUEN |
| Zip Code Of The Provider | 018444597 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 463 |
| Number Of Medicare Beneficiaries | 417 |
| Total Submitted Charge Amount | 198865 |
| Total Medicare Allowed Amount | 47995.22 |
| Total Medicare Payment Amount | 36417.81 |
| Total Medicare Standardized Payment Amount | 42892.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 463 |
| Number Of Medicare Beneficiaries With Medical Services | 417 |
| Total Medical Submitted Charge Amount | 198865 |
| Total Medical Medicare Allowed Amount | 47995.22 |
| Total Medical Medicare Payment Amount | 36417.81 |
| Total Medical Medicare Standardized Payment Amount | 42892.83 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 191 |
| Number Of Beneficiaries Age 65 to 74 | 94 |
| Number Of Beneficiaries Age 75 to 84 | 64 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 236 |
| Number Of Male Beneficiaries | 181 |
| Number Of Non Hispanic White Beneficiaries | 293 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 106 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 182 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 235 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 55 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.6134 |