| National Provider Identifier [NPI]: | 1831394402 |
| Last Name Of The Provider | CONLEY |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1705 EAST BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHARLOTTE |
| Zip Code Of The Provider | 282035800 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 3956 |
| Number Of Medicare Beneficiaries | 2871 |
| Total Submitted Charge Amount | 649231 |
| Total Medicare Allowed Amount | 121898.88 |
| Total Medicare Payment Amount | 94591.66 |
| Total Medicare Standardized Payment Amount | 99416.84 |
| 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 | 100 |
| Number Of Medical Services | 3956 |
| Number Of Medicare Beneficiaries With Medical Services | 2871 |
| Total Medical Submitted Charge Amount | 649231 |
| Total Medical Medicare Allowed Amount | 121898.88 |
| Total Medical Medicare Payment Amount | 94591.66 |
| Total Medical Medicare Standardized Payment Amount | 99416.84 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 739 |
| Number Of Beneficiaries Age 65 to 74 | 887 |
| Number Of Beneficiaries Age 75 to 84 | 759 |
| Number Of Beneficiaries Age Greater 84 | 486 |
| Number Of Female Beneficiaries | 1662 |
| Number Of Male Beneficiaries | 1209 |
| Number Of Non Hispanic White Beneficiaries | 2082 |
| Number Of Black or African American Beneficiaries | 679 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1848 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1023 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 22 |
| Average HCC Risk Score Of Beneficiaries | 2.0191 |