| National Provider Identifier [NPI]: | 1568564243 |
| Last Name Of The Provider | PETERSON |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7945 S SUNCOAST BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOMOSASSA |
| Zip Code Of The Provider | 344465005 |
| 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 | 51 |
| Number Of Services | 4523 |
| Number Of Medicare Beneficiaries | 1179 |
| Total Submitted Charge Amount | 362084 |
| Total Medicare Allowed Amount | 222035.46 |
| Total Medicare Payment Amount | 146781.97 |
| Total Medicare Standardized Payment Amount | 148368.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 363 |
| Number Of Medicare Beneficiaries With Drug Services | 184 |
| Total Drug Submitted ChargeAmount | 7663 |
| Total Drug Medicare AllowedAmount | 4738.1 |
| Total Drug Medicare PaymentAmount | 4386.54 |
| Total Drug Medicare Standardized Payment Amount | 4386.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 4160 |
| Number Of Medicare Beneficiaries With Medical Services | 1179 |
| Total Medical Submitted Charge Amount | 354421 |
| Total Medical Medicare Allowed Amount | 217297.36 |
| Total Medical Medicare Payment Amount | 142395.43 |
| Total Medical Medicare Standardized Payment Amount | 143981.67 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 509 |
| Number Of Beneficiaries Age 75 to 84 | 461 |
| Number Of Beneficiaries Age Greater 84 | 143 |
| Number Of Female Beneficiaries | 571 |
| Number Of Male Beneficiaries | 608 |
| Number Of Non Hispanic White Beneficiaries | 1130 |
| Number Of Black or African American Beneficiaries | 23 |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1116 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9841 |