| National Provider Identifier [NPI]: | 1457391732 |
| Last Name Of The Provider | PETROPOLIS |
| First Name Of The Provider | ANGELO |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1916 PASEO SAN LUIS |
| Street Address 2 Of The Provider | |
| City Of The Provider | SIERRA VISTA |
| Zip Code Of The Provider | 85635 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 118 |
| Number Of Services | 8789 |
| Number Of Medicare Beneficiaries | 1430 |
| Total Submitted Charge Amount | 1548897.5 |
| Total Medicare Allowed Amount | 815521.04 |
| Total Medicare Payment Amount | 610670.53 |
| Total Medicare Standardized Payment Amount | 607472.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 273 |
| Number Of Medicare Beneficiaries With Drug Services | 92 |
| Total Drug Submitted ChargeAmount | 13249.5 |
| Total Drug Medicare AllowedAmount | 11820.28 |
| Total Drug Medicare PaymentAmount | 9152.01 |
| Total Drug Medicare Standardized Payment Amount | 9152.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 116 |
| Number Of Medical Services | 8516 |
| Number Of Medicare Beneficiaries With Medical Services | 1430 |
| Total Medical Submitted Charge Amount | 1535648 |
| Total Medical Medicare Allowed Amount | 803700.76 |
| Total Medical Medicare Payment Amount | 601518.52 |
| Total Medical Medicare Standardized Payment Amount | 598320.59 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 685 |
| Number Of Beneficiaries Age 75 to 84 | 531 |
| Number Of Beneficiaries Age Greater 84 | 177 |
| Number Of Female Beneficiaries | 661 |
| Number Of Male Beneficiaries | 769 |
| Number Of Non Hispanic White Beneficiaries | 1361 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1400 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9042 |