| National Provider Identifier [NPI]: | 1932199940 |
| Last Name Of The Provider | PETERMANN |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 N OAK AVE |
| Street Address 2 Of The Provider | MARSHFIELD CLINIC |
| City Of The Provider | MARSHFIELD |
| Zip Code Of The Provider | 544495703 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 2410 |
| Number Of Medicare Beneficiaries | 1427 |
| Total Submitted Charge Amount | 691347.86 |
| Total Medicare Allowed Amount | 86784.96 |
| Total Medicare Payment Amount | 64718.83 |
| Total Medicare Standardized Payment Amount | 67031.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 646 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 2097.4 |
| Total Drug Medicare AllowedAmount | 450.57 |
| Total Drug Medicare PaymentAmount | 353.22 |
| Total Drug Medicare Standardized Payment Amount | 353.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 1764 |
| Number Of Medicare Beneficiaries With Medical Services | 1427 |
| Total Medical Submitted Charge Amount | 689250.46 |
| Total Medical Medicare Allowed Amount | 86334.39 |
| Total Medical Medicare Payment Amount | 64365.61 |
| Total Medical Medicare Standardized Payment Amount | 66678.36 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 315 |
| Number Of Beneficiaries Age 65 to 74 | 498 |
| Number Of Beneficiaries Age 75 to 84 | 395 |
| Number Of Beneficiaries Age Greater 84 | 219 |
| Number Of Female Beneficiaries | 818 |
| Number Of Male Beneficiaries | 609 |
| Number Of Non Hispanic White Beneficiaries | 1361 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 32 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 964 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 463 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5044 |