| National Provider Identifier [NPI]: | 1144273657 |
| Last Name Of The Provider | BETTONVILLE |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3844 S LINDBERGH BLVD. |
| Street Address 2 Of The Provider | SUITE 160 |
| City Of The Provider | ST. LOUIS |
| Zip Code Of The Provider | 63127 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 2263 |
| Number Of Medicare Beneficiaries | 345 |
| Total Submitted Charge Amount | 233285 |
| Total Medicare Allowed Amount | 149878.46 |
| Total Medicare Payment Amount | 110398.82 |
| Total Medicare Standardized Payment Amount | 112398.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 452 |
| Number Of Medicare Beneficiaries With Drug Services | 190 |
| Total Drug Submitted ChargeAmount | 34958 |
| Total Drug Medicare AllowedAmount | 22472.89 |
| Total Drug Medicare PaymentAmount | 21469.33 |
| Total Drug Medicare Standardized Payment Amount | 21469.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 1811 |
| Number Of Medicare Beneficiaries With Medical Services | 345 |
| Total Medical Submitted Charge Amount | 198327 |
| Total Medical Medicare Allowed Amount | 127405.57 |
| Total Medical Medicare Payment Amount | 88929.49 |
| Total Medical Medicare Standardized Payment Amount | 90928.7 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 149 |
| Number Of Beneficiaries Age 75 to 84 | 108 |
| Number Of Beneficiaries Age Greater 84 | 70 |
| Number Of Female Beneficiaries | 173 |
| Number Of Male Beneficiaries | 172 |
| Number Of Non Hispanic White Beneficiaries | 326 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 333 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8046 |