| National Provider Identifier [NPI]: | 1205263589 |
| Last Name Of The Provider | PETERMAN |
| First Name Of The Provider | MEGAN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | RN, FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1207 MAPLE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FARMINGTON |
| Zip Code Of The Provider | 636407616 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 386 |
| Number Of Medicare Beneficiaries | 326 |
| Total Submitted Charge Amount | 254562 |
| Total Medicare Allowed Amount | 39827.85 |
| Total Medicare Payment Amount | 30094.45 |
| Total Medicare Standardized Payment Amount | 35803.32 |
| 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 | 31 |
| Number Of Medical Services | 386 |
| Number Of Medicare Beneficiaries With Medical Services | 326 |
| Total Medical Submitted Charge Amount | 254562 |
| Total Medical Medicare Allowed Amount | 39827.85 |
| Total Medical Medicare Payment Amount | 30094.45 |
| Total Medical Medicare Standardized Payment Amount | 35803.32 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 189 |
| Number Of Beneficiaries Age 65 to 74 | 84 |
| Number Of Beneficiaries Age 75 to 84 | 33 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 180 |
| Number Of Male Beneficiaries | 146 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 165 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 161 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 56 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 18 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5356 |