Peter Merritt Lear , MSW LCSW, LAC

Medicare-allowed amount

About $2,694 in 2021

The total amount Medicare approved for these services in 2021. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.

It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.

Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2021.

Paid by Medicare

About $1,721 in 2021

The part of the Medicare-allowed amount that Medicare itself paid in 2021, after patients' deductibles and coinsurance.

The gap between the allowed amount and this number is roughly what patients and their other insurance paid.

Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2021.

Years since graduation

25 years (graduated 2001)

CMS Doctors and Clinicians data list 2001 as the year this clinician finished professional school.

It tells you roughly how long ago the clinician finished school.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2006

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

With Original Medicare, you usually pay only your deductible and coinsurance, and the office sends the claim to Medicare for you.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

Telehealth (some services)

Recent Medicare claims show this clinician provided some services by telehealth, such as a video or phone visit.

You may be able to have some visits without going to the office. Ask which visits can be done by telehealth.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Peter Lear has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Peter Lear as eligible to order or refer Medicare Part B clinical laboratory and imaging services and durable medical equipment (DME) for people with Medicare.

Medicare pays for these items and services only when they are ordered by an eligible clinician.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means