| National Provider Identifier [NPI]: | 1386658409 |
| Last Name Of The Provider | DONNELLY |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1004 CARONDELET DR |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | KANSAS CITY |
| Zip Code Of The Provider | 641144802 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 1983 |
| Number Of Medicare Beneficiaries | 1128 |
| Total Submitted Charge Amount | 508169 |
| Total Medicare Allowed Amount | 288498.38 |
| Total Medicare Payment Amount | 202733.81 |
| Total Medicare Standardized Payment Amount | 213328.61 |
| 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 | 29 |
| Number Of Medical Services | 1983 |
| Number Of Medicare Beneficiaries With Medical Services | 1128 |
| Total Medical Submitted Charge Amount | 508169 |
| Total Medical Medicare Allowed Amount | 288498.38 |
| Total Medical Medicare Payment Amount | 202733.81 |
| Total Medical Medicare Standardized Payment Amount | 213328.61 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 342 |
| Number Of Beneficiaries Age 75 to 84 | 485 |
| Number Of Beneficiaries Age Greater 84 | 277 |
| Number Of Female Beneficiaries | 659 |
| Number Of Male Beneficiaries | 469 |
| Number Of Non Hispanic White Beneficiaries | 1068 |
| Number Of Black or African American Beneficiaries | 38 |
| 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 | 1114 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0353 |