| National Provider Identifier [NPI]: | 1598799496 |
| Last Name Of The Provider | MATTSON |
| First Name Of The Provider | ANNE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6425 W MEQUON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MEQUON |
| Zip Code Of The Provider | 530921855 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 1439 |
| Number Of Medicare Beneficiaries | 203 |
| Total Submitted Charge Amount | 206759.44 |
| Total Medicare Allowed Amount | 64061.56 |
| Total Medicare Payment Amount | 48233.18 |
| Total Medicare Standardized Payment Amount | 50495.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 88 |
| Number Of Medicare Beneficiaries With Drug Services | 80 |
| Total Drug Submitted ChargeAmount | 4547.44 |
| Total Drug Medicare AllowedAmount | 2693.4 |
| Total Drug Medicare PaymentAmount | 2632.31 |
| Total Drug Medicare Standardized Payment Amount | 2632.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 1351 |
| Number Of Medicare Beneficiaries With Medical Services | 203 |
| Total Medical Submitted Charge Amount | 202212 |
| Total Medical Medicare Allowed Amount | 61368.16 |
| Total Medical Medicare Payment Amount | 45600.87 |
| Total Medical Medicare Standardized Payment Amount | 47863.14 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 109 |
| Number Of Beneficiaries Age 75 to 84 | 48 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 149 |
| Number Of Male Beneficiaries | 54 |
| Number Of Non Hispanic White Beneficiaries | 183 |
| Number Of Black or African American Beneficiaries | |
| 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 | 192 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8712 |