| National Provider Identifier [NPI]: | 1851581789 |
| Last Name Of The Provider | PETER |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5456 15 MILE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | STERLING HEIGHTS |
| Zip Code Of The Provider | 483105110 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 13301 |
| Number Of Medicare Beneficiaries | 415 |
| Total Submitted Charge Amount | 3787841 |
| Total Medicare Allowed Amount | 631881.31 |
| Total Medicare Payment Amount | 516462.18 |
| Total Medicare Standardized Payment Amount | 490606.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 689 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 22615 |
| Total Drug Medicare AllowedAmount | 6930.64 |
| Total Drug Medicare PaymentAmount | 5433.74 |
| Total Drug Medicare Standardized Payment Amount | 5433.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 12612 |
| Number Of Medicare Beneficiaries With Medical Services | 415 |
| Total Medical Submitted Charge Amount | 3765226 |
| Total Medical Medicare Allowed Amount | 624950.67 |
| Total Medical Medicare Payment Amount | 511028.44 |
| Total Medical Medicare Standardized Payment Amount | 485172.85 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 232 |
| Number Of Beneficiaries Age 65 to 74 | 99 |
| Number Of Beneficiaries Age 75 to 84 | 61 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 243 |
| Number Of Male Beneficiaries | 172 |
| Number Of Non Hispanic White Beneficiaries | 353 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 283 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 132 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.638 |