| National Provider Identifier [NPI]: | 1225142557 |
| Last Name Of The Provider | MATHENY |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1739 E BEVERLY AVE |
| Street Address 2 Of The Provider | SUITE 203 |
| City Of The Provider | KINGMAN |
| Zip Code Of The Provider | 864093593 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 3209 |
| Number Of Medicare Beneficiaries | 1010 |
| Total Submitted Charge Amount | 779555 |
| Total Medicare Allowed Amount | 258755.28 |
| Total Medicare Payment Amount | 194961.36 |
| Total Medicare Standardized Payment Amount | 198100.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 80 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 1319 |
| Total Drug Medicare AllowedAmount | 777.46 |
| Total Drug Medicare PaymentAmount | 676.69 |
| Total Drug Medicare Standardized Payment Amount | 676.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 3129 |
| Number Of Medicare Beneficiaries With Medical Services | 1010 |
| Total Medical Submitted Charge Amount | 778236 |
| Total Medical Medicare Allowed Amount | 257977.82 |
| Total Medical Medicare Payment Amount | 194284.67 |
| Total Medical Medicare Standardized Payment Amount | 197423.65 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 137 |
| Number Of Beneficiaries Age 65 to 74 | 441 |
| Number Of Beneficiaries Age 75 to 84 | 334 |
| Number Of Beneficiaries Age Greater 84 | 98 |
| Number Of Female Beneficiaries | 513 |
| Number Of Male Beneficiaries | 497 |
| Number Of Non Hispanic White Beneficiaries | 939 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | 20 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 817 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 193 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 65 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7922 |