| National Provider Identifier [NPI]: | 1194728956 |
| Last Name Of The Provider | FAHEY |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3334 CAPITAL MEDICAL BLVD |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | TALLAHASSEE |
| Zip Code Of The Provider | 323084470 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 2289 |
| Number Of Medicare Beneficiaries | 670 |
| Total Submitted Charge Amount | 1147852 |
| Total Medicare Allowed Amount | 259580.95 |
| Total Medicare Payment Amount | 194838.89 |
| Total Medicare Standardized Payment Amount | 193929.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 480 |
| Number Of Medicare Beneficiaries With Drug Services | 162 |
| Total Drug Submitted ChargeAmount | 13185 |
| Total Drug Medicare AllowedAmount | 4329.5 |
| Total Drug Medicare PaymentAmount | 3295.99 |
| Total Drug Medicare Standardized Payment Amount | 3295.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 1809 |
| Number Of Medicare Beneficiaries With Medical Services | 670 |
| Total Medical Submitted Charge Amount | 1134667 |
| Total Medical Medicare Allowed Amount | 255251.45 |
| Total Medical Medicare Payment Amount | 191542.9 |
| Total Medical Medicare Standardized Payment Amount | 190633.08 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 103 |
| Number Of Beneficiaries Age 65 to 74 | 299 |
| Number Of Beneficiaries Age 75 to 84 | 193 |
| Number Of Beneficiaries Age Greater 84 | 75 |
| Number Of Female Beneficiaries | 443 |
| Number Of Male Beneficiaries | 227 |
| Number Of Non Hispanic White Beneficiaries | 535 |
| Number Of Black or African American Beneficiaries | 120 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 541 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 129 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 70 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0291 |