| National Provider Identifier [NPI]: | 1982834834 |
| Last Name Of The Provider | PETERSON |
| First Name Of The Provider | JARED |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 220 S 63RD STREET |
| Street Address 2 Of The Provider | SWAGEL-WOOTTON-HIATT EYE CENTER |
| City Of The Provider | MESA |
| Zip Code Of The Provider | 85206 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 2738 |
| Number Of Medicare Beneficiaries | 1203 |
| Total Submitted Charge Amount | 694187.37 |
| Total Medicare Allowed Amount | 357061.22 |
| Total Medicare Payment Amount | 246902.72 |
| Total Medicare Standardized Payment Amount | 251137.35 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 562 |
| Number Of Beneficiaries Age 75 to 84 | 439 |
| Number Of Beneficiaries Age Greater 84 | 176 |
| Number Of Female Beneficiaries | 732 |
| Number Of Male Beneficiaries | 471 |
| Number Of Non Hispanic White Beneficiaries | 1112 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1180 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0278 |