| National Provider Identifier [NPI]: | 1417015959 |
| Last Name Of The Provider | MCKIERNAN |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2160 S 1ST AVE |
| Street Address 2 Of The Provider | (300 N. YORK RD., ELMHURST, IL. 60126) |
| City Of The Provider | MAYWOOD |
| Zip Code Of The Provider | 601533328 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 6848 |
| Number Of Medicare Beneficiaries | 3678 |
| Total Submitted Charge Amount | 872757 |
| Total Medicare Allowed Amount | 192370.47 |
| Total Medicare Payment Amount | 142261.87 |
| Total Medicare Standardized Payment Amount | 132777.77 |
| 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 | 20 |
| Number Of Medical Services | 6848 |
| Number Of Medicare Beneficiaries With Medical Services | 3678 |
| Total Medical Submitted Charge Amount | 872757 |
| Total Medical Medicare Allowed Amount | 192370.47 |
| Total Medical Medicare Payment Amount | 142261.87 |
| Total Medical Medicare Standardized Payment Amount | 132777.77 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 540 |
| Number Of Beneficiaries Age 65 to 74 | 1413 |
| Number Of Beneficiaries Age 75 to 84 | 1159 |
| Number Of Beneficiaries Age Greater 84 | 566 |
| Number Of Female Beneficiaries | 1820 |
| Number Of Male Beneficiaries | 1858 |
| Number Of Non Hispanic White Beneficiaries | 2702 |
| Number Of Black or African American Beneficiaries | 609 |
| Number Of AsianPacific Islander Beneficiaries | 61 |
| Number Of Hispanic Beneficiaries | 260 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2874 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 804 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0076 |