| National Provider Identifier [NPI]: | 1760546915 |
| Last Name Of The Provider | AHERN |
| First Name Of The Provider | CAROL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19270 HIGHWAY 12 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SONOMA |
| Zip Code Of The Provider | 954765414 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 219 |
| Number Of Medicare Beneficiaries | 93 |
| Total Submitted Charge Amount | 4951.3 |
| Total Medicare Allowed Amount | 1807.26 |
| Total Medicare Payment Amount | 1575.75 |
| Total Medicare Standardized Payment Amount | 1576.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 47 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 462.3 |
| Total Drug Medicare AllowedAmount | 76.28 |
| Total Drug Medicare PaymentAmount | 36.66 |
| Total Drug Medicare Standardized Payment Amount | 36.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 5 |
| Number Of Medical Services | 172 |
| Number Of Medicare Beneficiaries With Medical Services | 83 |
| Total Medical Submitted Charge Amount | 4489 |
| Total Medical Medicare Allowed Amount | 1730.98 |
| Total Medical Medicare Payment Amount | 1539.09 |
| Total Medical Medicare Standardized Payment Amount | 1539.57 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 45 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 55 |
| Number Of Male Beneficiaries | 38 |
| Number Of Non Hispanic White Beneficiaries | 55 |
| Number Of Black or African American Beneficiaries | |
| 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 | 24 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 71 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.394 |