| National Provider Identifier [NPI]: | 1982876397 |
| Last Name Of The Provider | CONNEELY |
| First Name Of The Provider | KERRY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1555 BARRINGTON RD |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY |
| City Of The Provider | HOFFMAN ESTATES |
| Zip Code Of The Provider | 601691019 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 169 |
| Number Of Services | 3083 |
| Number Of Medicare Beneficiaries | 1994 |
| Total Submitted Charge Amount | 343082 |
| Total Medicare Allowed Amount | 92441.07 |
| Total Medicare Payment Amount | 70214.04 |
| Total Medicare Standardized Payment Amount | 66367.99 |
| 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 | 169 |
| Number Of Medical Services | 3083 |
| Number Of Medicare Beneficiaries With Medical Services | 1994 |
| Total Medical Submitted Charge Amount | 343082 |
| Total Medical Medicare Allowed Amount | 92441.07 |
| Total Medical Medicare Payment Amount | 70214.04 |
| Total Medical Medicare Standardized Payment Amount | 66367.99 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 241 |
| Number Of Beneficiaries Age 65 to 74 | 782 |
| Number Of Beneficiaries Age 75 to 84 | 553 |
| Number Of Beneficiaries Age Greater 84 | 418 |
| Number Of Female Beneficiaries | 1190 |
| Number Of Male Beneficiaries | 804 |
| Number Of Non Hispanic White Beneficiaries | 1582 |
| Number Of Black or African American Beneficiaries | 72 |
| Number Of AsianPacific Islander Beneficiaries | 167 |
| Number Of Hispanic Beneficiaries | 139 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1543 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 451 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8778 |