| National Provider Identifier [NPI]: | 1831196047 |
| Last Name Of The Provider | CONNER |
| First Name Of The Provider | DOUGLASS |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3560 DELAWARE ST |
| Street Address 2 Of The Provider | 209 |
| City Of The Provider | BEAUMONT |
| Zip Code Of The Provider | 777063059 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 221 |
| Number Of Services | 5155 |
| Number Of Medicare Beneficiaries | 3436 |
| Total Submitted Charge Amount | 664836 |
| Total Medicare Allowed Amount | 153139.81 |
| Total Medicare Payment Amount | 116285.9 |
| Total Medicare Standardized Payment Amount | 120554.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 221 |
| Number Of Medical Services | 5155 |
| Number Of Medicare Beneficiaries With Medical Services | 3436 |
| Total Medical Submitted Charge Amount | 664836 |
| Total Medical Medicare Allowed Amount | 153139.81 |
| Total Medical Medicare Payment Amount | 116285.9 |
| Total Medical Medicare Standardized Payment Amount | 120554.49 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 608 |
| Number Of Beneficiaries Age 65 to 74 | 1304 |
| Number Of Beneficiaries Age 75 to 84 | 1024 |
| Number Of Beneficiaries Age Greater 84 | 500 |
| Number Of Female Beneficiaries | 2057 |
| Number Of Male Beneficiaries | 1379 |
| Number Of Non Hispanic White Beneficiaries | 2747 |
| Number Of Black or African American Beneficiaries | 587 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 70 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2585 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 851 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7637 |