| National Provider Identifier [NPI]: | 1518998327 |
| Last Name Of The Provider | MONAHAN |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 615 N MICHIGAN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTH BEND |
| Zip Code Of The Provider | 466011033 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 1087 |
| Number Of Medicare Beneficiaries | 800 |
| Total Submitted Charge Amount | 348144 |
| Total Medicare Allowed Amount | 89481.64 |
| Total Medicare Payment Amount | 64647.36 |
| Total Medicare Standardized Payment Amount | 67453.39 |
| 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 | 31 |
| Number Of Medical Services | 1087 |
| Number Of Medicare Beneficiaries With Medical Services | 800 |
| Total Medical Submitted Charge Amount | 348144 |
| Total Medical Medicare Allowed Amount | 89481.64 |
| Total Medical Medicare Payment Amount | 64647.36 |
| Total Medical Medicare Standardized Payment Amount | 67453.39 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 247 |
| Number Of Beneficiaries Age 65 to 74 | 199 |
| Number Of Beneficiaries Age 75 to 84 | 181 |
| Number Of Beneficiaries Age Greater 84 | 173 |
| Number Of Female Beneficiaries | 467 |
| Number Of Male Beneficiaries | 333 |
| Number Of Non Hispanic White Beneficiaries | 617 |
| Number Of Black or African American Beneficiaries | 140 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 486 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 314 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7019 |