National Provider Identifier [NPI]: |
1528033438 |
Last Name Of The Provider |
MATSON |
First Name Of The Provider |
CHRISTINE |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
825 FAIRFAX AVE |
Street Address 2 Of The Provider |
118 |
City Of The Provider |
NORFOLK |
Zip Code Of The Provider |
235071914 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
475 |
Number Of Medicare Beneficiaries |
264 |
Total Submitted Charge Amount |
53326 |
Total Medicare Allowed Amount |
32014.18 |
Total Medicare Payment Amount |
22043.7 |
Total Medicare Standardized Payment Amount |
22803.2 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
30 |
Number Of Medicare Beneficiaries With Drug Services |
26 |
Total Drug Submitted ChargeAmount |
1385 |
Total Drug Medicare AllowedAmount |
829 |
Total Drug Medicare PaymentAmount |
741.46 |
Total Drug Medicare Standardized Payment Amount |
741.46 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
445 |
Number Of Medicare Beneficiaries With Medical Services |
264 |
Total Medical Submitted Charge Amount |
51941 |
Total Medical Medicare Allowed Amount |
31185.18 |
Total Medical Medicare Payment Amount |
21302.24 |
Total Medical Medicare Standardized Payment Amount |
22061.74 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
116 |
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
46 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
174 |
Number Of Male Beneficiaries |
90 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
152 |
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 |
129 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
135 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5952 |