| National Provider Identifier [NPI]: | 1417927229 |
| Last Name Of The Provider | PETERS |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4402 CHURCHMAN AVE |
| Street Address 2 Of The Provider | SUITE 404 |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402151190 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 5631 |
| Number Of Medicare Beneficiaries | 853 |
| Total Submitted Charge Amount | 404906.16 |
| Total Medicare Allowed Amount | 254948.62 |
| Total Medicare Payment Amount | 184844.68 |
| Total Medicare Standardized Payment Amount | 206321.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1376 |
| Number Of Medicare Beneficiaries With Drug Services | 154 |
| Total Drug Submitted ChargeAmount | 6037.86 |
| Total Drug Medicare AllowedAmount | 4946.58 |
| Total Drug Medicare PaymentAmount | 3301.04 |
| Total Drug Medicare Standardized Payment Amount | 3301.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 4255 |
| Number Of Medicare Beneficiaries With Medical Services | 853 |
| Total Medical Submitted Charge Amount | 398868.3 |
| Total Medical Medicare Allowed Amount | 250002.04 |
| Total Medical Medicare Payment Amount | 181543.64 |
| Total Medical Medicare Standardized Payment Amount | 203020.63 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 482 |
| Number Of Beneficiaries Age 65 to 74 | 212 |
| Number Of Beneficiaries Age 75 to 84 | 119 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 504 |
| Number Of Male Beneficiaries | 349 |
| Number Of Non Hispanic White Beneficiaries | 803 |
| Number Of Black or African American Beneficiaries | 38 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 695 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 158 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2581 |