| National Provider Identifier [NPI]: | 1306034582 |
| Last Name Of The Provider | MATTOCH |
| First Name Of The Provider | INGERLISA |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1020 LUKE ST |
| Street Address 2 Of The Provider | SUITE D |
| City Of The Provider | FORT COLLINS |
| Zip Code Of The Provider | 805244067 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 9225 |
| Number Of Medicare Beneficiaries | 4255 |
| Total Submitted Charge Amount | 1272297.87 |
| Total Medicare Allowed Amount | 588360.1 |
| Total Medicare Payment Amount | 438017 |
| Total Medicare Standardized Payment Amount | 334668.04 |
| 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 | 14 |
| Number Of Medical Services | 9225 |
| Number Of Medicare Beneficiaries With Medical Services | 4255 |
| Total Medical Submitted Charge Amount | 1272297.87 |
| Total Medical Medicare Allowed Amount | 588360.1 |
| Total Medical Medicare Payment Amount | 438017 |
| Total Medical Medicare Standardized Payment Amount | 334668.04 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 156 |
| Number Of Beneficiaries Age 65 to 74 | 2076 |
| Number Of Beneficiaries Age 75 to 84 | 1350 |
| Number Of Beneficiaries Age Greater 84 | 673 |
| Number Of Female Beneficiaries | 2090 |
| Number Of Male Beneficiaries | 2165 |
| Number Of Non Hispanic White Beneficiaries | 4099 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 68 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 70 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4067 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 188 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8824 |