| National Provider Identifier [NPI]: | 1497761241 |
| Last Name Of The Provider | CONERLY |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 50 PARKWAY LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | PETAL |
| Zip Code Of The Provider | 394653035 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 7937 |
| Number Of Medicare Beneficiaries | 1336 |
| Total Submitted Charge Amount | 559688 |
| Total Medicare Allowed Amount | 346849.07 |
| Total Medicare Payment Amount | 240637.5 |
| Total Medicare Standardized Payment Amount | 265569.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 715 |
| Number Of Medicare Beneficiaries With Drug Services | 303 |
| Total Drug Submitted ChargeAmount | 19019 |
| Total Drug Medicare AllowedAmount | 5781.54 |
| Total Drug Medicare PaymentAmount | 5052.13 |
| Total Drug Medicare Standardized Payment Amount | 5052.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 7222 |
| Number Of Medicare Beneficiaries With Medical Services | 1336 |
| Total Medical Submitted Charge Amount | 540669 |
| Total Medical Medicare Allowed Amount | 341067.53 |
| Total Medical Medicare Payment Amount | 235585.37 |
| Total Medical Medicare Standardized Payment Amount | 260517.39 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 237 |
| Number Of Beneficiaries Age 65 to 74 | 484 |
| Number Of Beneficiaries Age 75 to 84 | 384 |
| Number Of Beneficiaries Age Greater 84 | 231 |
| Number Of Female Beneficiaries | 817 |
| Number Of Male Beneficiaries | 519 |
| Number Of Non Hispanic White Beneficiaries | 1180 |
| Number Of Black or African American Beneficiaries | 145 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 789 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 547 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.412 |