| National Provider Identifier [NPI]: | 1730146069 |
| Last Name Of The Provider | CONNELL |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1613 N MCKENZIE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FOLEY |
| Zip Code Of The Provider | 365352247 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 232 |
| Number Of Services | 10997 |
| Number Of Medicare Beneficiaries | 4636 |
| Total Submitted Charge Amount | 1275686 |
| Total Medicare Allowed Amount | 329805.26 |
| Total Medicare Payment Amount | 256726.05 |
| Total Medicare Standardized Payment Amount | 273579.82 |
| 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 | 232 |
| Number Of Medical Services | 10997 |
| Number Of Medicare Beneficiaries With Medical Services | 4636 |
| Total Medical Submitted Charge Amount | 1275686 |
| Total Medical Medicare Allowed Amount | 329805.26 |
| Total Medical Medicare Payment Amount | 256726.05 |
| Total Medical Medicare Standardized Payment Amount | 273579.82 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 677 |
| Number Of Beneficiaries Age 65 to 74 | 1985 |
| Number Of Beneficiaries Age 75 to 84 | 1445 |
| Number Of Beneficiaries Age Greater 84 | 529 |
| Number Of Female Beneficiaries | 2875 |
| Number Of Male Beneficiaries | 1761 |
| Number Of Non Hispanic White Beneficiaries | 4406 |
| Number Of Black or African American Beneficiaries | 134 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4076 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 560 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2318 |