| National Provider Identifier [NPI]: | 1780765719 |
| Last Name Of The Provider | MATHESON |
| First Name Of The Provider | DEREK |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3500 FRANK PHILLIPS |
| Street Address 2 Of The Provider | HOSPITALIST |
| City Of The Provider | BARTLESVILLE |
| Zip Code Of The Provider | 74006 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 2606 |
| Number Of Medicare Beneficiaries | 765 |
| Total Submitted Charge Amount | 522524 |
| Total Medicare Allowed Amount | 236202.67 |
| Total Medicare Payment Amount | 182327.39 |
| Total Medicare Standardized Payment Amount | 177070.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 2606 |
| Number Of Medicare Beneficiaries With Medical Services | 765 |
| Total Medical Submitted Charge Amount | 522524 |
| Total Medical Medicare Allowed Amount | 236202.67 |
| Total Medical Medicare Payment Amount | 182327.39 |
| Total Medical Medicare Standardized Payment Amount | 177070.76 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 107 |
| Number Of Beneficiaries Age 65 to 74 | 197 |
| Number Of Beneficiaries Age 75 to 84 | 264 |
| Number Of Beneficiaries Age Greater 84 | 197 |
| Number Of Female Beneficiaries | 418 |
| Number Of Male Beneficiaries | 347 |
| Number Of Non Hispanic White Beneficiaries | 663 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 77 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 554 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 211 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.8641 |