National Provider Identifier [NPI]: |
1356382535 |
Last Name Of The Provider |
MATTIO |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1305 W AMERICAN DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEENAH |
Zip Code Of The Provider |
549561993 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
40189 |
Number Of Medicare Beneficiaries |
395 |
Total Submitted Charge Amount |
1279417.71 |
Total Medicare Allowed Amount |
320959.08 |
Total Medicare Payment Amount |
240426.05 |
Total Medicare Standardized Payment Amount |
240683.74 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
39113 |
Number Of Medicare Beneficiaries With Drug Services |
88 |
Total Drug Submitted ChargeAmount |
638874.71 |
Total Drug Medicare AllowedAmount |
216537.19 |
Total Drug Medicare PaymentAmount |
165059.5 |
Total Drug Medicare Standardized Payment Amount |
165059.5 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
70 |
Number Of Medical Services |
1076 |
Number Of Medicare Beneficiaries With Medical Services |
395 |
Total Medical Submitted Charge Amount |
640543 |
Total Medical Medicare Allowed Amount |
104421.89 |
Total Medical Medicare Payment Amount |
75366.55 |
Total Medical Medicare Standardized Payment Amount |
75624.24 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
112 |
Number Of Beneficiaries Age 65 to 74 |
150 |
Number Of Beneficiaries Age 75 to 84 |
95 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
214 |
Number Of Male Beneficiaries |
181 |
Number Of Non Hispanic White Beneficiaries |
379 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
280 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
26 |
Average HCC Risk Score Of Beneficiaries |
1.333 |