| National Provider Identifier [NPI]: | 1144209404 |
| Last Name Of The Provider | PELTON |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D., PH.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 455 E PIKES PEAK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLORADO SPRINGS |
| Zip Code Of The Provider | 809033648 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Plastic and Reconstructive Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 4755 |
| Number Of Medicare Beneficiaries | 581 |
| Total Submitted Charge Amount | 966010 |
| Total Medicare Allowed Amount | 422288.37 |
| Total Medicare Payment Amount | 321302.2 |
| Total Medicare Standardized Payment Amount | 274800.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 3045 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 18570 |
| Total Drug Medicare AllowedAmount | 16755.52 |
| Total Drug Medicare PaymentAmount | 12977.13 |
| Total Drug Medicare Standardized Payment Amount | 12977.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 1710 |
| Number Of Medicare Beneficiaries With Medical Services | 581 |
| Total Medical Submitted Charge Amount | 947440 |
| Total Medical Medicare Allowed Amount | 405532.85 |
| Total Medical Medicare Payment Amount | 308325.07 |
| Total Medical Medicare Standardized Payment Amount | 261822.89 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 277 |
| Number Of Beneficiaries Age 75 to 84 | 182 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 347 |
| Number Of Male Beneficiaries | 234 |
| Number Of Non Hispanic White Beneficiaries | 504 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 536 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 45 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.028 |