| National Provider Identifier [NPI]: | 1750313094 |
| Last Name Of The Provider | STADNYK |
| 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 | 12303 DEPAUL DR |
| Street Address 2 Of The Provider | DEPAUL HEALTH CENTER |
| City Of The Provider | BRIDGETON |
| Zip Code Of The Provider | 63044 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 161 |
| Number Of Services | 7434 |
| Number Of Medicare Beneficiaries | 4360 |
| Total Submitted Charge Amount | 671014.29 |
| Total Medicare Allowed Amount | 177201.09 |
| Total Medicare Payment Amount | 139427.62 |
| Total Medicare Standardized Payment Amount | 143031.86 |
| 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 | 161 |
| Number Of Medical Services | 7434 |
| Number Of Medicare Beneficiaries With Medical Services | 4360 |
| Total Medical Submitted Charge Amount | 671014.29 |
| Total Medical Medicare Allowed Amount | 177201.09 |
| Total Medical Medicare Payment Amount | 139427.62 |
| Total Medical Medicare Standardized Payment Amount | 143031.86 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 918 |
| Number Of Beneficiaries Age 65 to 74 | 1653 |
| Number Of Beneficiaries Age 75 to 84 | 1116 |
| Number Of Beneficiaries Age Greater 84 | 673 |
| Number Of Female Beneficiaries | 2798 |
| Number Of Male Beneficiaries | 1562 |
| Number Of Non Hispanic White Beneficiaries | 3539 |
| Number Of Black or African American Beneficiaries | 727 |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3331 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1029 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.84 |