| National Provider Identifier [NPI]: | 1114106036 |
| Last Name Of The Provider | MCDONNELL |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 46-001 KAMEHAMEHA HWY STE 401 |
| Street Address 2 Of The Provider | |
| City Of The Provider | KANEOHE |
| Zip Code Of The Provider | 967443788 |
| State Code Of The Provider | HI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 1609 |
| Number Of Medicare Beneficiaries | 125 |
| Total Submitted Charge Amount | 117633.56 |
| Total Medicare Allowed Amount | 69911.33 |
| Total Medicare Payment Amount | 51455.72 |
| Total Medicare Standardized Payment Amount | 48339.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 144 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 3822.08 |
| Total Drug Medicare AllowedAmount | 3307.92 |
| Total Drug Medicare PaymentAmount | 2659.5 |
| Total Drug Medicare Standardized Payment Amount | 2659.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 1465 |
| Number Of Medicare Beneficiaries With Medical Services | 125 |
| Total Medical Submitted Charge Amount | 113811.48 |
| Total Medical Medicare Allowed Amount | 66603.41 |
| Total Medical Medicare Payment Amount | 48796.22 |
| Total Medical Medicare Standardized Payment Amount | 45680.07 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 62 |
| Number Of Beneficiaries Age 75 to 84 | 42 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 82 |
| Number Of Male Beneficiaries | 43 |
| Number Of Non Hispanic White Beneficiaries | 43 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 63 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 58 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8347 |