National Provider Identifier [NPI]: |
1255368957 |
Last Name Of The Provider |
PETERS |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
425 BRIGHTON ST |
Street Address 2 Of The Provider |
#303 |
City Of The Provider |
BETHLEHEM |
Zip Code Of The Provider |
180151273 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
113 |
Number Of Services |
4080 |
Number Of Medicare Beneficiaries |
2865 |
Total Submitted Charge Amount |
498616 |
Total Medicare Allowed Amount |
127428.45 |
Total Medicare Payment Amount |
97075.19 |
Total Medicare Standardized Payment Amount |
98748.45 |
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 |
113 |
Number Of Medical Services |
4080 |
Number Of Medicare Beneficiaries With Medical Services |
2865 |
Total Medical Submitted Charge Amount |
498616 |
Total Medical Medicare Allowed Amount |
127428.45 |
Total Medical Medicare Payment Amount |
97075.19 |
Total Medical Medicare Standardized Payment Amount |
98748.45 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
466 |
Number Of Beneficiaries Age 65 to 74 |
855 |
Number Of Beneficiaries Age 75 to 84 |
875 |
Number Of Beneficiaries Age Greater 84 |
669 |
Number Of Female Beneficiaries |
1668 |
Number Of Male Beneficiaries |
1197 |
Number Of Non Hispanic White Beneficiaries |
2565 |
Number Of Black or African American Beneficiaries |
63 |
Number Of AsianPacific Islander Beneficiaries |
28 |
Number Of Hispanic Beneficiaries |
180 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
2200 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
665 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.8688 |