| National Provider Identifier [NPI]: | 1932160397 |
| Last Name Of The Provider | PETERSON |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 119 W IRON AVE |
| Street Address 2 Of The Provider | 5TH FLOOR |
| City Of The Provider | SALINA |
| Zip Code Of The Provider | 674012600 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 118 |
| Number Of Services | 1322 |
| Number Of Medicare Beneficiaries | 886 |
| Total Submitted Charge Amount | 112871.2 |
| Total Medicare Allowed Amount | 35209.8 |
| Total Medicare Payment Amount | 28536.86 |
| Total Medicare Standardized Payment Amount | 29895.56 |
| 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 | 118 |
| Number Of Medical Services | 1322 |
| Number Of Medicare Beneficiaries With Medical Services | 886 |
| Total Medical Submitted Charge Amount | 112871.2 |
| Total Medical Medicare Allowed Amount | 35209.8 |
| Total Medical Medicare Payment Amount | 28536.86 |
| Total Medical Medicare Standardized Payment Amount | 29895.56 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 89 |
| Number Of Beneficiaries Age 65 to 74 | 312 |
| Number Of Beneficiaries Age 75 to 84 | 275 |
| Number Of Beneficiaries Age Greater 84 | 210 |
| Number Of Female Beneficiaries | 645 |
| Number Of Male Beneficiaries | 241 |
| Number Of Non Hispanic White Beneficiaries | 854 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 730 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 156 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1518 |