| National Provider Identifier [NPI]: | 1679562680 |
| Last Name Of The Provider | PETRUS |
| First Name Of The Provider | LEONARD |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MEDICAL DOCTOR |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 W CALIFORNIA BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PASADENA |
| Zip Code Of The Provider | 911053010 |
| 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 | 147 |
| Number Of Services | 17076 |
| Number Of Medicare Beneficiaries | 2533 |
| Total Submitted Charge Amount | 1863984.88 |
| Total Medicare Allowed Amount | 407533.08 |
| Total Medicare Payment Amount | 308001.26 |
| Total Medicare Standardized Payment Amount | 279177.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 13288 |
| Number Of Medicare Beneficiaries With Drug Services | 174 |
| Total Drug Submitted ChargeAmount | 19229 |
| Total Drug Medicare AllowedAmount | 4957.94 |
| Total Drug Medicare PaymentAmount | 3874.97 |
| Total Drug Medicare Standardized Payment Amount | 3874.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 142 |
| Number Of Medical Services | 3788 |
| Number Of Medicare Beneficiaries With Medical Services | 2533 |
| Total Medical Submitted Charge Amount | 1844755.88 |
| Total Medical Medicare Allowed Amount | 402575.14 |
| Total Medical Medicare Payment Amount | 304126.29 |
| Total Medical Medicare Standardized Payment Amount | 275303.02 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 318 |
| Number Of Beneficiaries Age 65 to 74 | 867 |
| Number Of Beneficiaries Age 75 to 84 | 818 |
| Number Of Beneficiaries Age Greater 84 | 530 |
| Number Of Female Beneficiaries | 1518 |
| Number Of Male Beneficiaries | 1015 |
| Number Of Non Hispanic White Beneficiaries | 1525 |
| Number Of Black or African American Beneficiaries | 243 |
| Number Of AsianPacific Islander Beneficiaries | 254 |
| Number Of Hispanic Beneficiaries | 447 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1637 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 896 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9521 |