| National Provider Identifier [NPI]: | 1609812916 |
| Last Name Of The Provider | MATSUMOTO |
| First Name Of The Provider | MARIA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2281 PARAGON DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN JOSE |
| Zip Code Of The Provider | 951311307 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 134 |
| Number Of Services | 10036 |
| Number Of Medicare Beneficiaries | 2433 |
| Total Submitted Charge Amount | 1150254.65 |
| Total Medicare Allowed Amount | 342356.86 |
| Total Medicare Payment Amount | 251614.95 |
| Total Medicare Standardized Payment Amount | 197499.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 6778 |
| Number Of Medicare Beneficiaries With Drug Services | 94 |
| Total Drug Submitted ChargeAmount | 8440.5 |
| Total Drug Medicare AllowedAmount | 2000.43 |
| Total Drug Medicare PaymentAmount | 1473.58 |
| Total Drug Medicare Standardized Payment Amount | 1473.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 130 |
| Number Of Medical Services | 3258 |
| Number Of Medicare Beneficiaries With Medical Services | 2433 |
| Total Medical Submitted Charge Amount | 1141814.15 |
| Total Medical Medicare Allowed Amount | 340356.43 |
| Total Medical Medicare Payment Amount | 250141.37 |
| Total Medical Medicare Standardized Payment Amount | 196025.93 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 184 |
| Number Of Beneficiaries Age 65 to 74 | 1075 |
| Number Of Beneficiaries Age 75 to 84 | 813 |
| Number Of Beneficiaries Age Greater 84 | 361 |
| Number Of Female Beneficiaries | 1460 |
| Number Of Male Beneficiaries | 973 |
| Number Of Non Hispanic White Beneficiaries | 915 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 1118 |
| Number Of Hispanic Beneficiaries | 292 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 67 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1214 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1219 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0969 |