| National Provider Identifier [NPI]: | 1982894853 |
| Last Name Of The Provider | DONALDSON |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3050 MONTVALE DR STE A |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627046924 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 146 |
| Number Of Services | 7500 |
| Number Of Medicare Beneficiaries | 4080 |
| Total Submitted Charge Amount | 777139.5 |
| Total Medicare Allowed Amount | 168088.75 |
| Total Medicare Payment Amount | 146049.79 |
| Total Medicare Standardized Payment Amount | 144950.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 146 |
| Number Of Medical Services | 7500 |
| Number Of Medicare Beneficiaries With Medical Services | 4080 |
| Total Medical Submitted Charge Amount | 777139.5 |
| Total Medical Medicare Allowed Amount | 168088.75 |
| Total Medical Medicare Payment Amount | 146049.79 |
| Total Medical Medicare Standardized Payment Amount | 144950.21 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 653 |
| Number Of Beneficiaries Age 65 to 74 | 1773 |
| Number Of Beneficiaries Age 75 to 84 | 1145 |
| Number Of Beneficiaries Age Greater 84 | 509 |
| Number Of Female Beneficiaries | 3338 |
| Number Of Male Beneficiaries | 742 |
| Number Of Non Hispanic White Beneficiaries | 3396 |
| Number Of Black or African American Beneficiaries | 583 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 41 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3116 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 964 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3711 |