| National Provider Identifier [NPI]: | 1487604625 |
| Last Name Of The Provider | PETREE |
| First Name Of The Provider | TRAVIS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1416 6TH ST SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | MASON CITY |
| Zip Code Of The Provider | 504014818 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 227 |
| Number Of Services | 9176 |
| Number Of Medicare Beneficiaries | 5643 |
| Total Submitted Charge Amount | 700149 |
| Total Medicare Allowed Amount | 233796.57 |
| Total Medicare Payment Amount | 182850.07 |
| Total Medicare Standardized Payment Amount | 194429.88 |
| 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 | 227 |
| Number Of Medical Services | 9176 |
| Number Of Medicare Beneficiaries With Medical Services | 5643 |
| Total Medical Submitted Charge Amount | 700149 |
| Total Medical Medicare Allowed Amount | 233796.57 |
| Total Medical Medicare Payment Amount | 182850.07 |
| Total Medical Medicare Standardized Payment Amount | 194429.88 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 578 |
| Number Of Beneficiaries Age 65 to 74 | 1947 |
| Number Of Beneficiaries Age 75 to 84 | 1892 |
| Number Of Beneficiaries Age Greater 84 | 1226 |
| Number Of Female Beneficiaries | 3438 |
| Number Of Male Beneficiaries | 2205 |
| Number Of Non Hispanic White Beneficiaries | 5517 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 49 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4634 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1009 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2808 |