| National Provider Identifier [NPI]: | 1285637330 |
| Last Name Of The Provider | SULLIVAN |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3501 JOHNSON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOLLYWOOD |
| Zip Code Of The Provider | 330215421 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 103 |
| Number Of Services | 2709 |
| Number Of Medicare Beneficiaries | 1590 |
| Total Submitted Charge Amount | 630802 |
| Total Medicare Allowed Amount | 152376.22 |
| Total Medicare Payment Amount | 115104.18 |
| Total Medicare Standardized Payment Amount | 112382.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 646 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 3876 |
| Total Drug Medicare AllowedAmount | 1215.02 |
| Total Drug Medicare PaymentAmount | 931.8 |
| Total Drug Medicare Standardized Payment Amount | 931.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 100 |
| Number Of Medical Services | 2063 |
| Number Of Medicare Beneficiaries With Medical Services | 1590 |
| Total Medical Submitted Charge Amount | 626926 |
| Total Medical Medicare Allowed Amount | 151161.2 |
| Total Medical Medicare Payment Amount | 114172.38 |
| Total Medical Medicare Standardized Payment Amount | 111450.44 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 303 |
| Number Of Beneficiaries Age 65 to 74 | 483 |
| Number Of Beneficiaries Age 75 to 84 | 466 |
| Number Of Beneficiaries Age Greater 84 | 338 |
| Number Of Female Beneficiaries | 1010 |
| Number Of Male Beneficiaries | 580 |
| Number Of Non Hispanic White Beneficiaries | 818 |
| Number Of Black or African American Beneficiaries | 272 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 455 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 844 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 746 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 25 |
| Average HCC Risk Score Of Beneficiaries | 2.1801 |