| National Provider Identifier [NPI]: | 1619959749 |
| Last Name Of The Provider | PECK |
| First Name Of The Provider | LEE |
| 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 | 6820 SOUTHPOINT PARKWAY |
| Street Address 2 Of The Provider | SUITE 6 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 32216 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 1799 |
| Number Of Medicare Beneficiaries | 608 |
| Total Submitted Charge Amount | 327440 |
| Total Medicare Allowed Amount | 225958.51 |
| Total Medicare Payment Amount | 173905.61 |
| Total Medicare Standardized Payment Amount | 172655.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 1799 |
| Number Of Medicare Beneficiaries With Medical Services | 608 |
| Total Medical Submitted Charge Amount | 327440 |
| Total Medical Medicare Allowed Amount | 225958.51 |
| Total Medical Medicare Payment Amount | 173905.61 |
| Total Medical Medicare Standardized Payment Amount | 172655.2 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 227 |
| Number Of Beneficiaries Age 65 to 74 | 168 |
| Number Of Beneficiaries Age 75 to 84 | 133 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 335 |
| Number Of Male Beneficiaries | 273 |
| Number Of Non Hispanic White Beneficiaries | 376 |
| Number Of Black or African American Beneficiaries | 203 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 304 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 304 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 35 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 52 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 29 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.7028 |