| National Provider Identifier [NPI]: | 1316144710 |
| Last Name Of The Provider | PETERSON |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 471 E BROAD ST STE 1400 |
| Street Address 2 Of The Provider | COLUMBUS RADIOLOGY |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432153806 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 230 |
| Number Of Services | 4257 |
| Number Of Medicare Beneficiaries | 2992 |
| Total Submitted Charge Amount | 739850 |
| Total Medicare Allowed Amount | 168932.02 |
| Total Medicare Payment Amount | 126314.29 |
| Total Medicare Standardized Payment Amount | 129602.85 |
| 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 | 230 |
| Number Of Medical Services | 4257 |
| Number Of Medicare Beneficiaries With Medical Services | 2992 |
| Total Medical Submitted Charge Amount | 739850 |
| Total Medical Medicare Allowed Amount | 168932.02 |
| Total Medical Medicare Payment Amount | 126314.29 |
| Total Medical Medicare Standardized Payment Amount | 129602.85 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 901 |
| Number Of Beneficiaries Age 65 to 74 | 976 |
| Number Of Beneficiaries Age 75 to 84 | 734 |
| Number Of Beneficiaries Age Greater 84 | 381 |
| Number Of Female Beneficiaries | 1668 |
| Number Of Male Beneficiaries | 1324 |
| Number Of Non Hispanic White Beneficiaries | 2611 |
| Number Of Black or African American Beneficiaries | 322 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1792 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1200 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.057 |