| National Provider Identifier [NPI]: | 1902858244 |
| Last Name Of The Provider | POWERS |
| First Name Of The Provider | MATTHEW |
| 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 | 1923 S UTICA AVE |
| Street Address 2 Of The Provider | SJMC RADIOLOGY |
| City Of The Provider | TULSA |
| Zip Code Of The Provider | 741046520 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 112 |
| Number Of Services | 8122 |
| Number Of Medicare Beneficiaries | 758 |
| Total Submitted Charge Amount | 461905.46 |
| Total Medicare Allowed Amount | 150064.17 |
| Total Medicare Payment Amount | 116933.25 |
| Total Medicare Standardized Payment Amount | 120386.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 6760 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 125137.52 |
| Total Drug Medicare AllowedAmount | 47143.04 |
| Total Drug Medicare PaymentAmount | 36844.9 |
| Total Drug Medicare Standardized Payment Amount | 36844.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 1362 |
| Number Of Medicare Beneficiaries With Medical Services | 758 |
| Total Medical Submitted Charge Amount | 336767.94 |
| Total Medical Medicare Allowed Amount | 102921.13 |
| Total Medical Medicare Payment Amount | 80088.35 |
| Total Medical Medicare Standardized Payment Amount | 83541.22 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 256 |
| Number Of Beneficiaries Age 65 to 74 | 314 |
| Number Of Beneficiaries Age 75 to 84 | 153 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 442 |
| Number Of Male Beneficiaries | 316 |
| Number Of Non Hispanic White Beneficiaries | 654 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 56 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 572 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 186 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1213 |