| National Provider Identifier [NPI]: | 1487638789 |
| Last Name Of The Provider | TETERS |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6913 N MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRANGER |
| Zip Code Of The Provider | 465309601 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 1040 |
| Number Of Medicare Beneficiaries | 232 |
| Total Submitted Charge Amount | 92528 |
| Total Medicare Allowed Amount | 56268.71 |
| Total Medicare Payment Amount | 38183.63 |
| Total Medicare Standardized Payment Amount | 41094.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 135 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 4886 |
| Total Drug Medicare AllowedAmount | 3184.6 |
| Total Drug Medicare PaymentAmount | 3087.16 |
| Total Drug Medicare Standardized Payment Amount | 3087.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 905 |
| Number Of Medicare Beneficiaries With Medical Services | 232 |
| Total Medical Submitted Charge Amount | 87642 |
| Total Medical Medicare Allowed Amount | 53084.11 |
| Total Medical Medicare Payment Amount | 35096.47 |
| Total Medical Medicare Standardized Payment Amount | 38006.93 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 104 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 122 |
| Number Of Male Beneficiaries | 110 |
| Number Of Non Hispanic White Beneficiaries | 211 |
| 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 | 181 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.8818 |