| National Provider Identifier [NPI]: | 1154369304 |
| Last Name Of The Provider | PETERSON |
| First Name Of The Provider | RICHARD |
| 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 | 191 E ORCHARD RD |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | LITTLETON |
| Zip Code Of The Provider | 801218000 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 1105 |
| Number Of Medicare Beneficiaries | 320 |
| Total Submitted Charge Amount | 75797 |
| Total Medicare Allowed Amount | 39540.79 |
| Total Medicare Payment Amount | 29372.36 |
| Total Medicare Standardized Payment Amount | 29327.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 492 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 1862 |
| Total Drug Medicare AllowedAmount | 941.83 |
| Total Drug Medicare PaymentAmount | 858.34 |
| Total Drug Medicare Standardized Payment Amount | 858.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 613 |
| Number Of Medicare Beneficiaries With Medical Services | 320 |
| Total Medical Submitted Charge Amount | 73935 |
| Total Medical Medicare Allowed Amount | 38598.96 |
| Total Medical Medicare Payment Amount | 28514.02 |
| Total Medical Medicare Standardized Payment Amount | 28468.92 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 127 |
| Number Of Beneficiaries Age 65 to 74 | 100 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 177 |
| Number Of Male Beneficiaries | 143 |
| Number Of Non Hispanic White Beneficiaries | 250 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 174 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 146 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.331 |