| National Provider Identifier [NPI]: | 1326042029 |
| Last Name Of The Provider | MATHIS |
| First Name Of The Provider | CHARLES |
| 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 | 500 ARCADE AVE |
| Street Address 2 Of The Provider | STE 400 |
| City Of The Provider | ELKHART |
| Zip Code Of The Provider | 465142477 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 3415 |
| Number Of Medicare Beneficiaries | 1522 |
| Total Submitted Charge Amount | 354699 |
| Total Medicare Allowed Amount | 196295.73 |
| Total Medicare Payment Amount | 143500.35 |
| Total Medicare Standardized Payment Amount | 152030.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 20 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 685 |
| Total Drug Medicare AllowedAmount | 646.07 |
| Total Drug Medicare PaymentAmount | 633.1 |
| Total Drug Medicare Standardized Payment Amount | 633.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 3395 |
| Number Of Medicare Beneficiaries With Medical Services | 1522 |
| Total Medical Submitted Charge Amount | 354014 |
| Total Medical Medicare Allowed Amount | 195649.66 |
| Total Medical Medicare Payment Amount | 142867.25 |
| Total Medical Medicare Standardized Payment Amount | 151397.72 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 183 |
| Number Of Beneficiaries Age 65 to 74 | 553 |
| Number Of Beneficiaries Age 75 to 84 | 528 |
| Number Of Beneficiaries Age Greater 84 | 258 |
| Number Of Female Beneficiaries | 760 |
| Number Of Male Beneficiaries | 762 |
| Number Of Non Hispanic White Beneficiaries | 1406 |
| Number Of Black or African American Beneficiaries | 65 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1225 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 297 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4288 |