| National Provider Identifier [NPI]: | 1972674844 |
| Last Name Of The Provider | PETERSON |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 615 LILLY RD NE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | OLYMPIA |
| Zip Code Of The Provider | 985065117 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 1774 |
| Number Of Medicare Beneficiaries | 424 |
| Total Submitted Charge Amount | 802374.13 |
| Total Medicare Allowed Amount | 255398.96 |
| Total Medicare Payment Amount | 190709.36 |
| Total Medicare Standardized Payment Amount | 197757.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 193 |
| Number Of Medicare Beneficiaries With Drug Services | 127 |
| Total Drug Submitted ChargeAmount | 10641.88 |
| Total Drug Medicare AllowedAmount | 5901.84 |
| Total Drug Medicare PaymentAmount | 4605.45 |
| Total Drug Medicare Standardized Payment Amount | 4605.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 1581 |
| Number Of Medicare Beneficiaries With Medical Services | 424 |
| Total Medical Submitted Charge Amount | 791732.25 |
| Total Medical Medicare Allowed Amount | 249497.12 |
| Total Medical Medicare Payment Amount | 186103.91 |
| Total Medical Medicare Standardized Payment Amount | 193151.81 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 172 |
| Number Of Beneficiaries Age 75 to 84 | 140 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 239 |
| Number Of Male Beneficiaries | 185 |
| Number Of Non Hispanic White Beneficiaries | 394 |
| 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 | 355 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2166 |