| National Provider Identifier [NPI]: | 1902880313 |
| Last Name Of The Provider | KEITHAHN |
| First Name Of The Provider | MARI |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3600 AMRON CT |
| Street Address 2 Of The Provider | BLDG 5B |
| City Of The Provider | COLUMBIA |
| Zip Code Of The Provider | 652021918 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 16164 |
| Number Of Medicare Beneficiaries | 1352 |
| Total Submitted Charge Amount | 9023210 |
| Total Medicare Allowed Amount | 4899322.75 |
| Total Medicare Payment Amount | 3792362.87 |
| Total Medicare Standardized Payment Amount | 3868607.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 5040 |
| Number Of Medicare Beneficiaries With Drug Services | 355 |
| Total Drug Submitted ChargeAmount | 5800890 |
| Total Drug Medicare AllowedAmount | 3893447.73 |
| Total Drug Medicare PaymentAmount | 3048784.43 |
| Total Drug Medicare Standardized Payment Amount | 3048784.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 11124 |
| Number Of Medicare Beneficiaries With Medical Services | 1352 |
| Total Medical Submitted Charge Amount | 3222320 |
| Total Medical Medicare Allowed Amount | 1005875.02 |
| Total Medical Medicare Payment Amount | 743578.44 |
| Total Medical Medicare Standardized Payment Amount | 819822.96 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 87 |
| Number Of Beneficiaries Age 65 to 74 | 507 |
| Number Of Beneficiaries Age 75 to 84 | 459 |
| Number Of Beneficiaries Age Greater 84 | 299 |
| Number Of Female Beneficiaries | 815 |
| Number Of Male Beneficiaries | 537 |
| Number Of Non Hispanic White Beneficiaries | 1311 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1203 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 149 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2506 |