National Provider Identifier [NPI]: |
1275765950 |
Last Name Of The Provider |
PETERS |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1 TAMPA GENERAL CIR |
Street Address 2 Of The Provider |
J402 |
City Of The Provider |
TAMPA |
Zip Code Of The Provider |
336063571 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1229 |
Number Of Medicare Beneficiaries |
434 |
Total Submitted Charge Amount |
304619 |
Total Medicare Allowed Amount |
130878.15 |
Total Medicare Payment Amount |
102568.92 |
Total Medicare Standardized Payment Amount |
98035.98 |
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 |
17 |
Number Of Medical Services |
1229 |
Number Of Medicare Beneficiaries With Medical Services |
434 |
Total Medical Submitted Charge Amount |
304619 |
Total Medical Medicare Allowed Amount |
130878.15 |
Total Medical Medicare Payment Amount |
102568.92 |
Total Medical Medicare Standardized Payment Amount |
98035.98 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
107 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
113 |
Number Of Female Beneficiaries |
233 |
Number Of Male Beneficiaries |
201 |
Number Of Non Hispanic White Beneficiaries |
339 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
52 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
293 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
141 |
Percent Of With Atrial Fibrillation |
35 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
70 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.3182 |