National Provider Identifier [NPI]: |
1376720920 |
Last Name Of The Provider |
PELTIER |
First Name Of The Provider |
HEATHER |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3780 EISENHOWER PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
MACON |
Zip Code Of The Provider |
312060800 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
416 |
Number Of Medicare Beneficiaries |
219 |
Total Submitted Charge Amount |
77255 |
Total Medicare Allowed Amount |
38369.69 |
Total Medicare Payment Amount |
29966.15 |
Total Medicare Standardized Payment Amount |
31093.87 |
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 |
5 |
Number Of Medical Services |
416 |
Number Of Medicare Beneficiaries With Medical Services |
219 |
Total Medical Submitted Charge Amount |
77255 |
Total Medical Medicare Allowed Amount |
38369.69 |
Total Medical Medicare Payment Amount |
29966.15 |
Total Medical Medicare Standardized Payment Amount |
31093.87 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
68 |
Number Of Beneficiaries Age 75 to 84 |
65 |
Number Of Beneficiaries Age Greater 84 |
30 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
101 |
Number Of Non Hispanic White Beneficiaries |
143 |
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 |
145 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
74 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
56 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
58 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
25 |
Average HCC Risk Score Of Beneficiaries |
2.9916 |