| National Provider Identifier [NPI]: | 1306827688 |
| Last Name Of The Provider | MATLEN |
| First Name Of The Provider | JERRY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 26025 LAHSER RD |
| Street Address 2 Of The Provider | 2ND FLOOR |
| City Of The Provider | SOUTHFIELD |
| Zip Code Of The Provider | 480332601 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 1869 |
| Number Of Medicare Beneficiaries | 301 |
| Total Submitted Charge Amount | 331319 |
| Total Medicare Allowed Amount | 154705.24 |
| Total Medicare Payment Amount | 115369.89 |
| Total Medicare Standardized Payment Amount | 107619.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 484 |
| Number Of Medicare Beneficiaries With Drug Services | 156 |
| Total Drug Submitted ChargeAmount | 42721 |
| Total Drug Medicare AllowedAmount | 18298.19 |
| Total Drug Medicare PaymentAmount | 14155.54 |
| Total Drug Medicare Standardized Payment Amount | 14155.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 1385 |
| Number Of Medicare Beneficiaries With Medical Services | 301 |
| Total Medical Submitted Charge Amount | 288598 |
| Total Medical Medicare Allowed Amount | 136407.05 |
| Total Medical Medicare Payment Amount | 101214.35 |
| Total Medical Medicare Standardized Payment Amount | 93463.9 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 140 |
| Number Of Beneficiaries Age 75 to 84 | 85 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 217 |
| Number Of Male Beneficiaries | 84 |
| Number Of Non Hispanic White Beneficiaries | 198 |
| Number Of Black or African American Beneficiaries | 78 |
| 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 | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 244 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1576 |