| National Provider Identifier [NPI]: | 1245496900 |
| Last Name Of The Provider | WETZEL |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1101 26TH STREET SOUTH |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | GREAT FALLS |
| Zip Code Of The Provider | 59405 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 163 |
| Number Of Services | 3329 |
| Number Of Medicare Beneficiaries | 2229 |
| Total Submitted Charge Amount | 355304.25 |
| Total Medicare Allowed Amount | 122896.73 |
| Total Medicare Payment Amount | 95636.86 |
| Total Medicare Standardized Payment Amount | 98137.53 |
| 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 | 163 |
| Number Of Medical Services | 3329 |
| Number Of Medicare Beneficiaries With Medical Services | 2229 |
| Total Medical Submitted Charge Amount | 355304.25 |
| Total Medical Medicare Allowed Amount | 122896.73 |
| Total Medical Medicare Payment Amount | 95636.86 |
| Total Medical Medicare Standardized Payment Amount | 98137.53 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 361 |
| Number Of Beneficiaries Age 65 to 74 | 847 |
| Number Of Beneficiaries Age 75 to 84 | 712 |
| Number Of Beneficiaries Age Greater 84 | 309 |
| Number Of Female Beneficiaries | 1309 |
| Number Of Male Beneficiaries | 920 |
| Number Of Non Hispanic White Beneficiaries | 2000 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | 125 |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1686 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 543 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4604 |