| National Provider Identifier [NPI]: | 1285936542 |
| Last Name Of The Provider | MATHERNE |
| First Name Of The Provider | DONOVAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | FNP-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9118 BLUEBONNET CENTRE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BATON ROUGE |
| Zip Code Of The Provider | 708092993 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 4154 |
| Number Of Medicare Beneficiaries | 736 |
| Total Submitted Charge Amount | 392688 |
| Total Medicare Allowed Amount | 146197.17 |
| Total Medicare Payment Amount | 115675.23 |
| Total Medicare Standardized Payment Amount | 134956.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 411 |
| Number Of Medicare Beneficiaries With Drug Services | 130 |
| Total Drug Submitted ChargeAmount | 3078 |
| Total Drug Medicare AllowedAmount | 328.97 |
| Total Drug Medicare PaymentAmount | 235.48 |
| Total Drug Medicare Standardized Payment Amount | 235.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 3743 |
| Number Of Medicare Beneficiaries With Medical Services | 736 |
| Total Medical Submitted Charge Amount | 389610 |
| Total Medical Medicare Allowed Amount | 145868.2 |
| Total Medical Medicare Payment Amount | 115439.75 |
| Total Medical Medicare Standardized Payment Amount | 134720.76 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 438 |
| Number Of Beneficiaries Age 65 to 74 | 168 |
| Number Of Beneficiaries Age 75 to 84 | 110 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 386 |
| Number Of Male Beneficiaries | 350 |
| Number Of Non Hispanic White Beneficiaries | 607 |
| Number Of Black or African American Beneficiaries | 101 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 431 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 305 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 73 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2498 |