National Provider Identifier [NPI]: |
1912051848 |
Last Name Of The Provider |
PETERSON |
First Name Of The Provider |
CHRISTINE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
500 UNIVERSITY DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
HERSHEY |
Zip Code Of The Provider |
170332360 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
82 |
Number Of Services |
1859 |
Number Of Medicare Beneficiaries |
1297 |
Total Submitted Charge Amount |
621140 |
Total Medicare Allowed Amount |
75885.57 |
Total Medicare Payment Amount |
56461.06 |
Total Medicare Standardized Payment Amount |
59171.01 |
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 |
82 |
Number Of Medical Services |
1859 |
Number Of Medicare Beneficiaries With Medical Services |
1297 |
Total Medical Submitted Charge Amount |
621140 |
Total Medical Medicare Allowed Amount |
75885.57 |
Total Medical Medicare Payment Amount |
56461.06 |
Total Medical Medicare Standardized Payment Amount |
59171.01 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
303 |
Number Of Beneficiaries Age 65 to 74 |
435 |
Number Of Beneficiaries Age 75 to 84 |
378 |
Number Of Beneficiaries Age Greater 84 |
181 |
Number Of Female Beneficiaries |
638 |
Number Of Male Beneficiaries |
659 |
Number Of Non Hispanic White Beneficiaries |
1180 |
Number Of Black or African American Beneficiaries |
46 |
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
37 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
23 |
Number Of Beneficiaries With Medicare Only Entitlement |
982 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
315 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0461 |