| National Provider Identifier [NPI]: | 1881773018 |
| Last Name Of The Provider | CORNELL |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 MEMORIAL BOULEVARD |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEWPORT |
| Zip Code Of The Provider | 028403679 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 3655 |
| Number Of Medicare Beneficiaries | 644 |
| Total Submitted Charge Amount | 168980 |
| Total Medicare Allowed Amount | 136532.26 |
| Total Medicare Payment Amount | 105190.78 |
| Total Medicare Standardized Payment Amount | 103437.53 |
| 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 | 21 |
| Number Of Medical Services | 3655 |
| Number Of Medicare Beneficiaries With Medical Services | 644 |
| Total Medical Submitted Charge Amount | 168980 |
| Total Medical Medicare Allowed Amount | 136532.26 |
| Total Medical Medicare Payment Amount | 105190.78 |
| Total Medical Medicare Standardized Payment Amount | 103437.53 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 204 |
| Number Of Beneficiaries Age Greater 84 | 293 |
| Number Of Female Beneficiaries | 394 |
| Number Of Male Beneficiaries | 250 |
| Number Of Non Hispanic White Beneficiaries | 610 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 473 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 171 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 33 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.575 |