| National Provider Identifier [NPI]: | 1508837352 |
| Last Name Of The Provider | PAUL |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9041 MAGNOLIA AVE |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | RIVERSIDE |
| Zip Code Of The Provider | 925033900 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 351 |
| Number Of Medicare Beneficiaries | 219 |
| Total Submitted Charge Amount | 29165 |
| Total Medicare Allowed Amount | 26013.56 |
| Total Medicare Payment Amount | 15794.5 |
| Total Medicare Standardized Payment Amount | 17128.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 20 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 315 |
| Total Drug Medicare AllowedAmount | 5.66 |
| Total Drug Medicare PaymentAmount | 3.06 |
| Total Drug Medicare Standardized Payment Amount | 3.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 331 |
| Number Of Medicare Beneficiaries With Medical Services | 219 |
| Total Medical Submitted Charge Amount | 28850 |
| Total Medical Medicare Allowed Amount | 26007.9 |
| Total Medical Medicare Payment Amount | 15791.44 |
| Total Medical Medicare Standardized Payment Amount | 17125.04 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 76 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 139 |
| Number Of Male Beneficiaries | 80 |
| Number Of Non Hispanic White Beneficiaries | 108 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 79 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 73 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 146 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.297 |