| National Provider Identifier [NPI]: | 1891776571 |
| Last Name Of The Provider | MAHAN |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3131 BERGER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921234203 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 3962 |
| Number Of Medicare Beneficiaries | 1335 |
| Total Submitted Charge Amount | 695719.99 |
| Total Medicare Allowed Amount | 295354.97 |
| Total Medicare Payment Amount | 215732.26 |
| Total Medicare Standardized Payment Amount | 208241.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 256 |
| Number Of Medicare Beneficiaries With Drug Services | 64 |
| Total Drug Submitted ChargeAmount | 19200 |
| Total Drug Medicare AllowedAmount | 13555.11 |
| Total Drug Medicare PaymentAmount | 9874.72 |
| Total Drug Medicare Standardized Payment Amount | 9874.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 3706 |
| Number Of Medicare Beneficiaries With Medical Services | 1333 |
| Total Medical Submitted Charge Amount | 676519.99 |
| Total Medical Medicare Allowed Amount | 281799.86 |
| Total Medical Medicare Payment Amount | 205857.54 |
| Total Medical Medicare Standardized Payment Amount | 198367.23 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 448 |
| Number Of Beneficiaries Age 75 to 84 | 492 |
| Number Of Beneficiaries Age Greater 84 | 296 |
| Number Of Female Beneficiaries | 618 |
| Number Of Male Beneficiaries | 717 |
| Number Of Non Hispanic White Beneficiaries | 979 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | 117 |
| Number Of Hispanic Beneficiaries | 135 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1056 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 279 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.6803 |