| National Provider Identifier [NPI]: | 1730117573 |
| Last Name Of The Provider | MATSUMURA |
| First Name Of The Provider | BRITTANY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 205 STAFFORD LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | DELTA |
| Zip Code Of The Provider | 814162229 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 10419 |
| Number Of Medicare Beneficiaries | 27 |
| Total Submitted Charge Amount | 118181 |
| Total Medicare Allowed Amount | 70524.76 |
| Total Medicare Payment Amount | 55206.31 |
| Total Medicare Standardized Payment Amount | 55180.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 10280 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 92320 |
| Total Drug Medicare AllowedAmount | 56601.27 |
| Total Drug Medicare PaymentAmount | 44375.32 |
| Total Drug Medicare Standardized Payment Amount | 44375.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 139 |
| Number Of Medicare Beneficiaries With Medical Services | 27 |
| Total Medical Submitted Charge Amount | 25861 |
| Total Medical Medicare Allowed Amount | 13923.49 |
| Total Medical Medicare Payment Amount | 10830.99 |
| Total Medical Medicare Standardized Payment Amount | 10805.34 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 16 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 0 |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 70 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1839 |