| National Provider Identifier [NPI]: | 1760496202 |
| Last Name Of The Provider | PETERSON |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1661 SOQUEL DR |
| Street Address 2 Of The Provider | BUILDING G |
| City Of The Provider | SANTA CRUZ |
| Zip Code Of The Provider | 950651709 |
| 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 | 177 |
| Number Of Services | 5076 |
| Number Of Medicare Beneficiaries | 2731 |
| Total Submitted Charge Amount | 401494 |
| Total Medicare Allowed Amount | 137045.19 |
| Total Medicare Payment Amount | 108037.84 |
| Total Medicare Standardized Payment Amount | 106764.04 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 485 |
| Number Of Beneficiaries Age 65 to 74 | 959 |
| Number Of Beneficiaries Age 75 to 84 | 749 |
| Number Of Beneficiaries Age Greater 84 | 538 |
| Number Of Female Beneficiaries | 1724 |
| Number Of Male Beneficiaries | 1007 |
| Number Of Non Hispanic White Beneficiaries | 1455 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | 100 |
| Number Of Hispanic Beneficiaries | 1102 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 42 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1609 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1122 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5137 |