| National Provider Identifier [NPI]: | 1174799787 |
| Last Name Of The Provider | PETERSON |
| First Name Of The Provider | RAMSEY |
| 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 | 8675 VALLEY CREEK ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WOODBURY |
| Zip Code Of The Provider | 551252337 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 915 |
| Number Of Medicare Beneficiaries | 188 |
| Total Submitted Charge Amount | 96875.45 |
| Total Medicare Allowed Amount | 42045.43 |
| Total Medicare Payment Amount | 30683.04 |
| Total Medicare Standardized Payment Amount | 32065.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 73 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 3545 |
| Total Drug Medicare AllowedAmount | 1596.4 |
| Total Drug Medicare PaymentAmount | 1523.93 |
| Total Drug Medicare Standardized Payment Amount | 1523.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 842 |
| Number Of Medicare Beneficiaries With Medical Services | 188 |
| Total Medical Submitted Charge Amount | 93330.45 |
| Total Medical Medicare Allowed Amount | 40449.03 |
| Total Medical Medicare Payment Amount | 29159.11 |
| Total Medical Medicare Standardized Payment Amount | 30542.01 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 105 |
| Number Of Male Beneficiaries | 83 |
| Number Of Non Hispanic White Beneficiaries | 169 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 147 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.1584 |