| National Provider Identifier [NPI]: | 1124096581 |
| Last Name Of The Provider | NICOLA |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6098 FM 311 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRING BRANCH |
| Zip Code Of The Provider | 780707253 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 3606 |
| Number Of Medicare Beneficiaries | 1060 |
| Total Submitted Charge Amount | 273960.03 |
| Total Medicare Allowed Amount | 191210.28 |
| Total Medicare Payment Amount | 135391.68 |
| Total Medicare Standardized Payment Amount | 143304 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 381 |
| Number Of Medicare Beneficiaries With Drug Services | 295 |
| Total Drug Submitted ChargeAmount | 11258.27 |
| Total Drug Medicare AllowedAmount | 6595.98 |
| Total Drug Medicare PaymentAmount | 6424.09 |
| Total Drug Medicare Standardized Payment Amount | 6424.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 3225 |
| Number Of Medicare Beneficiaries With Medical Services | 1059 |
| Total Medical Submitted Charge Amount | 262701.76 |
| Total Medical Medicare Allowed Amount | 184614.3 |
| Total Medical Medicare Payment Amount | 128967.59 |
| Total Medical Medicare Standardized Payment Amount | 136879.91 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 76 |
| Number Of Beneficiaries Age 65 to 74 | 636 |
| Number Of Beneficiaries Age 75 to 84 | 261 |
| Number Of Beneficiaries Age Greater 84 | 87 |
| Number Of Female Beneficiaries | 570 |
| Number Of Male Beneficiaries | 490 |
| Number Of Non Hispanic White Beneficiaries | 998 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1013 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.7826 |