| National Provider Identifier [NPI]: | 1265763163 |
| Last Name Of The Provider | MAHANEY |
| First Name Of The Provider | GRETCHEN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | APN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 102 W KENWOOD AVE STE 120 |
| Street Address 2 Of The Provider | |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 625266380 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 1396 |
| Number Of Medicare Beneficiaries | 899 |
| Total Submitted Charge Amount | 356900 |
| Total Medicare Allowed Amount | 114955.23 |
| Total Medicare Payment Amount | 86825.89 |
| Total Medicare Standardized Payment Amount | 105150.97 |
| 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 | 23 |
| Number Of Medical Services | 1396 |
| Number Of Medicare Beneficiaries With Medical Services | 899 |
| Total Medical Submitted Charge Amount | 356900 |
| Total Medical Medicare Allowed Amount | 114955.23 |
| Total Medical Medicare Payment Amount | 86825.89 |
| Total Medical Medicare Standardized Payment Amount | 105150.97 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 144 |
| Number Of Beneficiaries Age 65 to 74 | 335 |
| Number Of Beneficiaries Age 75 to 84 | 278 |
| Number Of Beneficiaries Age Greater 84 | 142 |
| Number Of Female Beneficiaries | 478 |
| Number Of Male Beneficiaries | 421 |
| Number Of Non Hispanic White Beneficiaries | 834 |
| Number Of Black or African American Beneficiaries | 48 |
| 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 | 699 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 200 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 74 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.8324 |