| National Provider Identifier [NPI]: | 1881851871 |
| Last Name Of The Provider | PELTON |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 70 DOCTOR'S PARK |
| Street Address 2 Of The Provider | |
| City Of The Provider | CAPE GIRARDEAU |
| Zip Code Of The Provider | 63703 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 158 |
| Number Of Services | 15698 |
| Number Of Medicare Beneficiaries | 7660 |
| Total Submitted Charge Amount | 1351042 |
| Total Medicare Allowed Amount | 377095.55 |
| Total Medicare Payment Amount | 294088.57 |
| Total Medicare Standardized Payment Amount | 311436.78 |
| 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 | 158 |
| Number Of Medical Services | 15698 |
| Number Of Medicare Beneficiaries With Medical Services | 7660 |
| Total Medical Submitted Charge Amount | 1351042 |
| Total Medical Medicare Allowed Amount | 377095.55 |
| Total Medical Medicare Payment Amount | 294088.57 |
| Total Medical Medicare Standardized Payment Amount | 311436.78 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 2159 |
| Number Of Beneficiaries Age 65 to 74 | 2564 |
| Number Of Beneficiaries Age 75 to 84 | 1929 |
| Number Of Beneficiaries Age Greater 84 | 1008 |
| Number Of Female Beneficiaries | 4744 |
| Number Of Male Beneficiaries | 2916 |
| Number Of Non Hispanic White Beneficiaries | 7208 |
| Number Of Black or African American Beneficiaries | 352 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4474 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 3186 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5484 |