| National Provider Identifier [NPI]: | 1316995699 |
| Last Name Of The Provider | MATHERN |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19646 N 27TH AVE |
| Street Address 2 Of The Provider | STE 406 |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850274017 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 138 |
| Number Of Services | 151114 |
| Number Of Medicare Beneficiaries | 587 |
| Total Submitted Charge Amount | 7662501 |
| Total Medicare Allowed Amount | 2127908.57 |
| Total Medicare Payment Amount | 1645936.39 |
| Total Medicare Standardized Payment Amount | 1640949.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 77 |
| Number Of Drug Services | 144887 |
| Number Of Medicare Beneficiaries With Drug Services | 224 |
| Total Drug Submitted ChargeAmount | 6519631 |
| Total Drug Medicare AllowedAmount | 1764997.15 |
| Total Drug Medicare PaymentAmount | 1364227.57 |
| Total Drug Medicare Standardized Payment Amount | 1364227.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 6227 |
| Number Of Medicare Beneficiaries With Medical Services | 587 |
| Total Medical Submitted Charge Amount | 1142870 |
| Total Medical Medicare Allowed Amount | 362911.42 |
| Total Medical Medicare Payment Amount | 281708.82 |
| Total Medical Medicare Standardized Payment Amount | 276722.21 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 299 |
| Number Of Beneficiaries Age 75 to 84 | 177 |
| Number Of Beneficiaries Age Greater 84 | 47 |
| Number Of Female Beneficiaries | 340 |
| Number Of Male Beneficiaries | 247 |
| Number Of Non Hispanic White Beneficiaries | 410 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | 108 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 468 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 119 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 50 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.8553 |