| National Provider Identifier [NPI]: | 1376565176 |
| Last Name Of The Provider | MAHONEY |
| First Name Of The Provider | DEBORAH |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1001 HART BLVD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MONTICELLO |
| Zip Code Of The Provider | 553628670 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 1190 |
| Number Of Medicare Beneficiaries | 129 |
| Total Submitted Charge Amount | 80127 |
| Total Medicare Allowed Amount | 39307.73 |
| Total Medicare Payment Amount | 28938.22 |
| Total Medicare Standardized Payment Amount | 30304.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 48 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 1818 |
| Total Drug Medicare AllowedAmount | 987.54 |
| Total Drug Medicare PaymentAmount | 955.64 |
| Total Drug Medicare Standardized Payment Amount | 955.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 1142 |
| Number Of Medicare Beneficiaries With Medical Services | 129 |
| Total Medical Submitted Charge Amount | 78309 |
| Total Medical Medicare Allowed Amount | 38320.19 |
| Total Medical Medicare Payment Amount | 27982.58 |
| Total Medical Medicare Standardized Payment Amount | 29348.73 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 40 |
| Number Of Beneficiaries Age 75 to 84 | 25 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 88 |
| Number Of Male Beneficiaries | 41 |
| 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 | 82 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0273 |