| National Provider Identifier [NPI]: | 1396783676 |
| Last Name Of The Provider | PETERS |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 133 ORNAC |
| Street Address 2 Of The Provider | EMERSON HOSPITAL |
| City Of The Provider | CONCORD |
| Zip Code Of The Provider | 01742 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 104 |
| Number Of Services | 3333 |
| Number Of Medicare Beneficiaries | 1888 |
| Total Submitted Charge Amount | 265938 |
| Total Medicare Allowed Amount | 83011.64 |
| Total Medicare Payment Amount | 65256.89 |
| Total Medicare Standardized Payment Amount | 63590.81 |
| 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 | 104 |
| Number Of Medical Services | 3333 |
| Number Of Medicare Beneficiaries With Medical Services | 1888 |
| Total Medical Submitted Charge Amount | 265938 |
| Total Medical Medicare Allowed Amount | 83011.64 |
| Total Medical Medicare Payment Amount | 65256.89 |
| Total Medical Medicare Standardized Payment Amount | 63590.81 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 170 |
| Number Of Beneficiaries Age 65 to 74 | 772 |
| Number Of Beneficiaries Age 75 to 84 | 598 |
| Number Of Beneficiaries Age Greater 84 | 348 |
| Number Of Female Beneficiaries | 1415 |
| Number Of Male Beneficiaries | 473 |
| Number Of Non Hispanic White Beneficiaries | 1784 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1660 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 228 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2061 |