| National Provider Identifier [NPI]: | 1962497933 |
| Last Name Of The Provider | MAHERN |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 642 S WALKER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLOOMINGTON |
| Zip Code Of The Provider | 474032158 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 1041 |
| Number Of Medicare Beneficiaries | 219 |
| Total Submitted Charge Amount | 106850 |
| Total Medicare Allowed Amount | 68862.74 |
| Total Medicare Payment Amount | 46424.97 |
| Total Medicare Standardized Payment Amount | 50112.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 147 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 10373 |
| Total Drug Medicare AllowedAmount | 5429.41 |
| Total Drug Medicare PaymentAmount | 5132.11 |
| Total Drug Medicare Standardized Payment Amount | 5132.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 894 |
| Number Of Medicare Beneficiaries With Medical Services | 219 |
| Total Medical Submitted Charge Amount | 96477 |
| Total Medical Medicare Allowed Amount | 63433.33 |
| Total Medical Medicare Payment Amount | 41292.86 |
| Total Medical Medicare Standardized Payment Amount | 44980.36 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 126 |
| Number Of Beneficiaries Age 75 to 84 | 48 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 173 |
| Number Of Male Beneficiaries | 46 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 191 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7661 |