| National Provider Identifier [NPI]: | 1245559749 |
| Last Name Of The Provider | MARTINSON |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | P.A.-C. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 324 ROXBURY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCKFORD |
| Zip Code Of The Provider | 611075090 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 1492 |
| Number Of Medicare Beneficiaries | 277 |
| Total Submitted Charge Amount | 433534 |
| Total Medicare Allowed Amount | 58808.18 |
| Total Medicare Payment Amount | 44452.87 |
| Total Medicare Standardized Payment Amount | 46250.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1070 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 24746 |
| Total Drug Medicare AllowedAmount | 12699.27 |
| Total Drug Medicare PaymentAmount | 9627.45 |
| Total Drug Medicare Standardized Payment Amount | 9627.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 422 |
| Number Of Medicare Beneficiaries With Medical Services | 276 |
| Total Medical Submitted Charge Amount | 408788 |
| Total Medical Medicare Allowed Amount | 46108.91 |
| Total Medical Medicare Payment Amount | 34825.42 |
| Total Medical Medicare Standardized Payment Amount | 36623.14 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 154 |
| Number Of Beneficiaries Age 75 to 84 | 66 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 187 |
| Number Of Male Beneficiaries | 90 |
| Number Of Non Hispanic White Beneficiaries | 237 |
| Number Of Black or African American Beneficiaries | 20 |
| 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 | 220 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0248 |