| National Provider Identifier [NPI]: | 1215130729 |
| Last Name Of The Provider | CONDON |
| First Name Of The Provider | MAUREEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 601 ELMWOOD AVE |
| Street Address 2 Of The Provider | BOX 655 |
| City Of The Provider | ROCHESTER |
| Zip Code Of The Provider | 146420001 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 779 |
| Number Of Medicare Beneficiaries | 483 |
| Total Submitted Charge Amount | 675179.07 |
| Total Medicare Allowed Amount | 98149.41 |
| Total Medicare Payment Amount | 75222.42 |
| Total Medicare Standardized Payment Amount | 67485.24 |
| 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 | 45 |
| Number Of Medical Services | 779 |
| Number Of Medicare Beneficiaries With Medical Services | 483 |
| Total Medical Submitted Charge Amount | 675179.07 |
| Total Medical Medicare Allowed Amount | 98149.41 |
| Total Medical Medicare Payment Amount | 75222.42 |
| Total Medical Medicare Standardized Payment Amount | 67485.24 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 153 |
| Number Of Beneficiaries Age 75 to 84 | 150 |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 265 |
| Number Of Male Beneficiaries | 218 |
| Number Of Non Hispanic White Beneficiaries | 329 |
| Number Of Black or African American Beneficiaries | 78 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 61 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 337 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 146 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9825 |