| National Provider Identifier [NPI]: | 1679540694 |
| Last Name Of The Provider | FEAGEANS |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4348 SOUTHPOINT BLVD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322160986 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 3467 |
| Number Of Medicare Beneficiaries | 301 |
| Total Submitted Charge Amount | 407797 |
| Total Medicare Allowed Amount | 342322.48 |
| Total Medicare Payment Amount | 255711.61 |
| Total Medicare Standardized Payment Amount | 256207.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 263 |
| Number Of Medicare Beneficiaries With Drug Services | 93 |
| Total Drug Submitted ChargeAmount | 2626.68 |
| Total Drug Medicare AllowedAmount | 1817.43 |
| Total Drug Medicare PaymentAmount | 1691.9 |
| Total Drug Medicare Standardized Payment Amount | 1691.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 3204 |
| Number Of Medicare Beneficiaries With Medical Services | 301 |
| Total Medical Submitted Charge Amount | 405170.32 |
| Total Medical Medicare Allowed Amount | 340505.05 |
| Total Medical Medicare Payment Amount | 254019.71 |
| Total Medical Medicare Standardized Payment Amount | 254515.35 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 44 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 134 |
| Number Of Female Beneficiaries | 218 |
| Number Of Male Beneficiaries | 83 |
| Number Of Non Hispanic White Beneficiaries | 230 |
| Number Of Black or African American Beneficiaries | 54 |
| 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 | 158 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 143 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 51 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.2068 |