| National Provider Identifier [NPI]: | 1205936044 |
| Last Name Of The Provider | PETERSEL |
| First Name Of The Provider | SHELDON |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5 WOOD CT |
| Street Address 2 Of The Provider | |
| City Of The Provider | SYOSSET |
| Zip Code Of The Provider | 117916518 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 3583 |
| Number Of Medicare Beneficiaries | 197 |
| Total Submitted Charge Amount | 435503 |
| Total Medicare Allowed Amount | 263703.67 |
| Total Medicare Payment Amount | 199430.45 |
| Total Medicare Standardized Payment Amount | 177008.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 546 |
| Number Of Medicare Beneficiaries With Drug Services | 129 |
| Total Drug Submitted ChargeAmount | 27450 |
| Total Drug Medicare AllowedAmount | 2324.24 |
| Total Drug Medicare PaymentAmount | 2083.66 |
| Total Drug Medicare Standardized Payment Amount | 2083.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 3037 |
| Number Of Medicare Beneficiaries With Medical Services | 197 |
| Total Medical Submitted Charge Amount | 408053 |
| Total Medical Medicare Allowed Amount | 261379.43 |
| Total Medical Medicare Payment Amount | 197346.79 |
| Total Medical Medicare Standardized Payment Amount | 174924.35 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 62 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | 94 |
| Number Of Female Beneficiaries | 118 |
| Number Of Male Beneficiaries | 79 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 179 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 41 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.42 |