| National Provider Identifier [NPI]: | 1528022712 |
| Last Name Of The Provider | PERSONIUS |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 183 FAIRVIEW LN |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | SONORA |
| Zip Code Of The Provider | 953704809 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 3129 |
| Number Of Medicare Beneficiaries | 455 |
| Total Submitted Charge Amount | 241198 |
| Total Medicare Allowed Amount | 221879.41 |
| Total Medicare Payment Amount | 154348.12 |
| Total Medicare Standardized Payment Amount | 158748.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 64 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 2592 |
| Total Drug Medicare AllowedAmount | 1017.31 |
| Total Drug Medicare PaymentAmount | 992.15 |
| Total Drug Medicare Standardized Payment Amount | 992.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 3065 |
| Number Of Medicare Beneficiaries With Medical Services | 455 |
| Total Medical Submitted Charge Amount | 238606 |
| Total Medical Medicare Allowed Amount | 220862.1 |
| Total Medical Medicare Payment Amount | 153355.97 |
| Total Medical Medicare Standardized Payment Amount | 157756.52 |
| Average Age Of Beneficiaries | 84 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | 117 |
| Number Of Beneficiaries Age Greater 84 | 268 |
| Number Of Female Beneficiaries | 299 |
| Number Of Male Beneficiaries | 156 |
| Number Of Non Hispanic White Beneficiaries | 426 |
| 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 | 251 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 204 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 64 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.9887 |