| National Provider Identifier [NPI]: | 1801851886 |
| Last Name Of The Provider | MATTINGLY |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5601 S 3RD ST |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402142615 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 15501 |
| Number Of Medicare Beneficiaries | 843 |
| Total Submitted Charge Amount | 548753 |
| Total Medicare Allowed Amount | 328884.76 |
| Total Medicare Payment Amount | 248705.02 |
| Total Medicare Standardized Payment Amount | 267439.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 2103 |
| Number Of Medicare Beneficiaries With Drug Services | 385 |
| Total Drug Submitted ChargeAmount | 53197 |
| Total Drug Medicare AllowedAmount | 16845.67 |
| Total Drug Medicare PaymentAmount | 14112.92 |
| Total Drug Medicare Standardized Payment Amount | 14112.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 13398 |
| Number Of Medicare Beneficiaries With Medical Services | 843 |
| Total Medical Submitted Charge Amount | 495556 |
| Total Medical Medicare Allowed Amount | 312039.09 |
| Total Medical Medicare Payment Amount | 234592.1 |
| Total Medical Medicare Standardized Payment Amount | 253326.13 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 135 |
| Number Of Beneficiaries Age 65 to 74 | 396 |
| Number Of Beneficiaries Age 75 to 84 | 221 |
| Number Of Beneficiaries Age Greater 84 | 91 |
| Number Of Female Beneficiaries | 465 |
| Number Of Male Beneficiaries | 378 |
| Number Of Non Hispanic White Beneficiaries | 807 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 766 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0769 |