| National Provider Identifier [NPI]: | 1225006901 |
| Last Name Of The Provider | NICHOLSON |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 736 IRVING AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SYRACUSE |
| Zip Code Of The Provider | 132101687 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 178 |
| Number Of Services | 5497 |
| Number Of Medicare Beneficiaries | 3141 |
| Total Submitted Charge Amount | 716589.4 |
| Total Medicare Allowed Amount | 174877.14 |
| Total Medicare Payment Amount | 136325.26 |
| Total Medicare Standardized Payment Amount | 141998.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 172 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 1720 |
| Total Drug Medicare AllowedAmount | 322.14 |
| Total Drug Medicare PaymentAmount | 226.28 |
| Total Drug Medicare Standardized Payment Amount | 226.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 176 |
| Number Of Medical Services | 5325 |
| Number Of Medicare Beneficiaries With Medical Services | 3141 |
| Total Medical Submitted Charge Amount | 714869.4 |
| Total Medical Medicare Allowed Amount | 174555 |
| Total Medical Medicare Payment Amount | 136098.98 |
| Total Medical Medicare Standardized Payment Amount | 141772.54 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 570 |
| Number Of Beneficiaries Age 65 to 74 | 1092 |
| Number Of Beneficiaries Age 75 to 84 | 938 |
| Number Of Beneficiaries Age Greater 84 | 541 |
| Number Of Female Beneficiaries | 2022 |
| Number Of Male Beneficiaries | 1119 |
| Number Of Non Hispanic White Beneficiaries | 2970 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2286 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 855 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5441 |