| National Provider Identifier [NPI]: | 1134163314 |
| Last Name Of The Provider | THOMSON |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 COFFEE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MODESTO |
| Zip Code Of The Provider | 953554201 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 255 |
| Number Of Services | 12266 |
| Number Of Medicare Beneficiaries | 3225 |
| Total Submitted Charge Amount | 1028073.18 |
| Total Medicare Allowed Amount | 269733.51 |
| Total Medicare Payment Amount | 209688.13 |
| Total Medicare Standardized Payment Amount | 218759.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 6100 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 18300 |
| Total Drug Medicare AllowedAmount | 1124.4 |
| Total Drug Medicare PaymentAmount | 867.84 |
| Total Drug Medicare Standardized Payment Amount | 867.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 254 |
| Number Of Medical Services | 6166 |
| Number Of Medicare Beneficiaries With Medical Services | 3225 |
| Total Medical Submitted Charge Amount | 1009773.18 |
| Total Medical Medicare Allowed Amount | 268609.11 |
| Total Medical Medicare Payment Amount | 208820.29 |
| Total Medical Medicare Standardized Payment Amount | 217891.59 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 612 |
| Number Of Beneficiaries Age 65 to 74 | 1270 |
| Number Of Beneficiaries Age 75 to 84 | 885 |
| Number Of Beneficiaries Age Greater 84 | 458 |
| Number Of Female Beneficiaries | 1906 |
| Number Of Male Beneficiaries | 1319 |
| Number Of Non Hispanic White Beneficiaries | 3008 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 68 |
| Number Of American Indian Alaska Native Beneficiaries | 68 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2399 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 826 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5125 |