| National Provider Identifier [NPI]: | 1609839083 |
| Last Name Of The Provider | PETTY |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1702 ESPLANADE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICO |
| Zip Code Of The Provider | 959263315 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 246 |
| Number Of Services | 26707 |
| Number Of Medicare Beneficiaries | 5055 |
| Total Submitted Charge Amount | 2000160 |
| Total Medicare Allowed Amount | 652585.3 |
| Total Medicare Payment Amount | 502777.26 |
| Total Medicare Standardized Payment Amount | 494066.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 18951 |
| Number Of Medicare Beneficiaries With Drug Services | 298 |
| Total Drug Submitted ChargeAmount | 37983 |
| Total Drug Medicare AllowedAmount | 5695.08 |
| Total Drug Medicare PaymentAmount | 4444.76 |
| Total Drug Medicare Standardized Payment Amount | 4444.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 240 |
| Number Of Medical Services | 7756 |
| Number Of Medicare Beneficiaries With Medical Services | 5055 |
| Total Medical Submitted Charge Amount | 1962177 |
| Total Medical Medicare Allowed Amount | 646890.22 |
| Total Medical Medicare Payment Amount | 498332.5 |
| Total Medical Medicare Standardized Payment Amount | 489621.87 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 960 |
| Number Of Beneficiaries Age 65 to 74 | 1827 |
| Number Of Beneficiaries Age 75 to 84 | 1436 |
| Number Of Beneficiaries Age Greater 84 | 832 |
| Number Of Female Beneficiaries | 2847 |
| Number Of Male Beneficiaries | 2208 |
| Number Of Non Hispanic White Beneficiaries | 4496 |
| Number Of Black or African American Beneficiaries | 66 |
| Number Of AsianPacific Islander Beneficiaries | 55 |
| Number Of Hispanic Beneficiaries | 325 |
| Number Of American Indian Alaska Native Beneficiaries | 78 |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3451 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1604 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6475 |