| National Provider Identifier [NPI]: | 1225182231 |
| Last Name Of The Provider | WEBBER |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8700 SUDLEY RD |
| Street Address 2 Of The Provider | PRINCE WILLIAM HOSPITAL RADIOLOGY DEPT |
| City Of The Provider | MANASSAS |
| Zip Code Of The Provider | 201104418 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 150 |
| Number Of Services | 3325 |
| Number Of Medicare Beneficiaries | 2260 |
| Total Submitted Charge Amount | 477245 |
| Total Medicare Allowed Amount | 95164.73 |
| Total Medicare Payment Amount | 70214.54 |
| Total Medicare Standardized Payment Amount | 72534.65 |
| 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 | 150 |
| Number Of Medical Services | 3325 |
| Number Of Medicare Beneficiaries With Medical Services | 2260 |
| Total Medical Submitted Charge Amount | 477245 |
| Total Medical Medicare Allowed Amount | 95164.73 |
| Total Medical Medicare Payment Amount | 70214.54 |
| Total Medical Medicare Standardized Payment Amount | 72534.65 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 306 |
| Number Of Beneficiaries Age 65 to 74 | 928 |
| Number Of Beneficiaries Age 75 to 84 | 658 |
| Number Of Beneficiaries Age Greater 84 | 368 |
| Number Of Female Beneficiaries | 1463 |
| Number Of Male Beneficiaries | 797 |
| Number Of Non Hispanic White Beneficiaries | 1853 |
| Number Of Black or African American Beneficiaries | 247 |
| Number Of AsianPacific Islander Beneficiaries | 53 |
| Number Of Hispanic Beneficiaries | 77 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1798 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 462 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5221 |