| National Provider Identifier [NPI]: | 1699715144 |
| Last Name Of The Provider | CONN |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 840 OAKWOOD BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DEARBORN |
| Zip Code Of The Provider | 481242319 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 181 |
| Number Of Services | 5804 |
| Number Of Medicare Beneficiaries | 3771 |
| Total Submitted Charge Amount | 495437 |
| Total Medicare Allowed Amount | 190795.74 |
| Total Medicare Payment Amount | 146686.4 |
| Total Medicare Standardized Payment Amount | 144189.17 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
| Total Drug Medicare AllowedAmount | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 851 |
| Number Of Beneficiaries Age 65 to 74 | 1208 |
| Number Of Beneficiaries Age 75 to 84 | 1007 |
| Number Of Beneficiaries Age Greater 84 | 705 |
| Number Of Female Beneficiaries | 2328 |
| Number Of Male Beneficiaries | 1443 |
| Number Of Non Hispanic White Beneficiaries | 2834 |
| Number Of Black or African American Beneficiaries | 694 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 127 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 70 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2478 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1293 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 46 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.257 |