| National Provider Identifier [NPI]: | 1609863778 |
| Last Name Of The Provider | MAHAN |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 W KALEY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORLANDO |
| Zip Code Of The Provider | 328062931 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 182 |
| Number Of Services | 7514 |
| Number Of Medicare Beneficiaries | 4241 |
| Total Submitted Charge Amount | 732997 |
| Total Medicare Allowed Amount | 210527.72 |
| Total Medicare Payment Amount | 158127 |
| Total Medicare Standardized Payment Amount | 157961.2 |
| 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 | 182 |
| Number Of Medical Services | 7514 |
| Number Of Medicare Beneficiaries With Medical Services | 4241 |
| Total Medical Submitted Charge Amount | 732997 |
| Total Medical Medicare Allowed Amount | 210527.72 |
| Total Medical Medicare Payment Amount | 158127 |
| Total Medical Medicare Standardized Payment Amount | 157961.2 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 725 |
| Number Of Beneficiaries Age 65 to 74 | 1485 |
| Number Of Beneficiaries Age 75 to 84 | 1324 |
| Number Of Beneficiaries Age Greater 84 | 707 |
| Number Of Female Beneficiaries | 2691 |
| Number Of Male Beneficiaries | 1550 |
| Number Of Non Hispanic White Beneficiaries | 2911 |
| Number Of Black or African American Beneficiaries | 713 |
| Number Of AsianPacific Islander Beneficiaries | 92 |
| Number Of Hispanic Beneficiaries | 436 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3049 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1192 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9378 |