| National Provider Identifier [NPI]: | 1427008812 |
| Last Name Of The Provider | PETERSON |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 575 S STATE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | OREM |
| Zip Code Of The Provider | 840586303 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 509 |
| Number Of Medicare Beneficiaries | 94 |
| Total Submitted Charge Amount | 43431 |
| Total Medicare Allowed Amount | 26618.3 |
| Total Medicare Payment Amount | 18913.52 |
| Total Medicare Standardized Payment Amount | 19890.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 42 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 1741 |
| Total Drug Medicare AllowedAmount | 1348.19 |
| Total Drug Medicare PaymentAmount | 1320.7 |
| Total Drug Medicare Standardized Payment Amount | 1320.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 467 |
| Number Of Medicare Beneficiaries With Medical Services | 94 |
| Total Medical Submitted Charge Amount | 41690 |
| Total Medical Medicare Allowed Amount | 25270.11 |
| Total Medical Medicare Payment Amount | 17592.82 |
| Total Medical Medicare Standardized Payment Amount | 18569.35 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 42 |
| Number Of Beneficiaries Age 75 to 84 | 36 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 50 |
| Number Of Male Beneficiaries | 44 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 35 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.6701 |