| National Provider Identifier [NPI]: | 1083611057 |
| Last Name Of The Provider | ANDERSON |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4100 HARRISON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BATESVILLE |
| Zip Code Of The Provider | 725019419 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 567 |
| Number Of Medicare Beneficiaries | 177 |
| Total Submitted Charge Amount | 21699.5 |
| Total Medicare Allowed Amount | 12718.08 |
| Total Medicare Payment Amount | 5562.81 |
| Total Medicare Standardized Payment Amount | 7477.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 170 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 2391 |
| Total Drug Medicare AllowedAmount | 1338.07 |
| Total Drug Medicare PaymentAmount | 969.44 |
| Total Drug Medicare Standardized Payment Amount | 969.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 397 |
| Number Of Medicare Beneficiaries With Medical Services | 175 |
| Total Medical Submitted Charge Amount | 19308.5 |
| Total Medical Medicare Allowed Amount | 11380.01 |
| Total Medical Medicare Payment Amount | 4593.37 |
| Total Medical Medicare Standardized Payment Amount | 6508.33 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 73 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 112 |
| Number Of Male Beneficiaries | 65 |
| Number Of Non Hispanic White Beneficiaries | 165 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 114 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1202 |