| National Provider Identifier [NPI]: | 1245260132 |
| Last Name Of The Provider | MCCORMACK |
| First Name Of The Provider | MAUREEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2020 PALOMINO LN |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891064894 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 171 |
| Number Of Services | 9189 |
| Number Of Medicare Beneficiaries | 3481 |
| Total Submitted Charge Amount | 933399.94 |
| Total Medicare Allowed Amount | 271158.61 |
| Total Medicare Payment Amount | 220345.17 |
| Total Medicare Standardized Payment Amount | 216884.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 3677 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 9471 |
| Total Drug Medicare AllowedAmount | 1140.38 |
| Total Drug Medicare PaymentAmount | 894.02 |
| Total Drug Medicare Standardized Payment Amount | 894.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 167 |
| Number Of Medical Services | 5512 |
| Number Of Medicare Beneficiaries With Medical Services | 3481 |
| Total Medical Submitted Charge Amount | 923928.94 |
| Total Medical Medicare Allowed Amount | 270018.23 |
| Total Medical Medicare Payment Amount | 219451.15 |
| Total Medical Medicare Standardized Payment Amount | 215990.5 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 716 |
| Number Of Beneficiaries Age 65 to 74 | 1484 |
| Number Of Beneficiaries Age 75 to 84 | 900 |
| Number Of Beneficiaries Age Greater 84 | 381 |
| Number Of Female Beneficiaries | 2212 |
| Number Of Male Beneficiaries | 1269 |
| Number Of Non Hispanic White Beneficiaries | 2367 |
| Number Of Black or African American Beneficiaries | 480 |
| Number Of AsianPacific Islander Beneficiaries | 183 |
| Number Of Hispanic Beneficiaries | 369 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 67 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2491 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 990 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9287 |