| National Provider Identifier [NPI]: | 1780860411 |
| Last Name Of The Provider | MATTAR |
| First Name Of The Provider | COSTY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2101 N WALDRON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HUTCHINSON |
| Zip Code Of The Provider | 675021131 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 2388 |
| Number Of Medicare Beneficiaries | 647 |
| Total Submitted Charge Amount | 875520 |
| Total Medicare Allowed Amount | 194762.55 |
| Total Medicare Payment Amount | 151916.8 |
| Total Medicare Standardized Payment Amount | 161506.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 259 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 44445 |
| Total Drug Medicare AllowedAmount | 7916.14 |
| Total Drug Medicare PaymentAmount | 6206.22 |
| Total Drug Medicare Standardized Payment Amount | 6206.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 2129 |
| Number Of Medicare Beneficiaries With Medical Services | 647 |
| Total Medical Submitted Charge Amount | 831075 |
| Total Medical Medicare Allowed Amount | 186846.41 |
| Total Medical Medicare Payment Amount | 145710.58 |
| Total Medical Medicare Standardized Payment Amount | 155300.03 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 238 |
| Number Of Beneficiaries Age 75 to 84 | 230 |
| Number Of Beneficiaries Age Greater 84 | 119 |
| Number Of Female Beneficiaries | 341 |
| Number Of Male Beneficiaries | 306 |
| Number Of Non Hispanic White Beneficiaries | 621 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 555 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2371 |