| National Provider Identifier [NPI]: | 1982666236 |
| Last Name Of The Provider | CANNON |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 818 N EMPORIA ST |
| Street Address 2 Of The Provider | SUITE 403 |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 672143729 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 174 |
| Number Of Services | 103716 |
| Number Of Medicare Beneficiaries | 861 |
| Total Submitted Charge Amount | 3133401.4 |
| Total Medicare Allowed Amount | 1485118.71 |
| Total Medicare Payment Amount | 1147274.66 |
| Total Medicare Standardized Payment Amount | 1159476.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 82 |
| Number Of Drug Services | 95134 |
| Number Of Medicare Beneficiaries With Drug Services | 298 |
| Total Drug Submitted ChargeAmount | 2454356.4 |
| Total Drug Medicare AllowedAmount | 1176890.94 |
| Total Drug Medicare PaymentAmount | 911573.86 |
| Total Drug Medicare Standardized Payment Amount | 911573.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 8582 |
| Number Of Medicare Beneficiaries With Medical Services | 861 |
| Total Medical Submitted Charge Amount | 679045 |
| Total Medical Medicare Allowed Amount | 308227.77 |
| Total Medical Medicare Payment Amount | 235700.8 |
| Total Medical Medicare Standardized Payment Amount | 247902.28 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 102 |
| Number Of Beneficiaries Age 65 to 74 | 351 |
| Number Of Beneficiaries Age 75 to 84 | 296 |
| Number Of Beneficiaries Age Greater 84 | 112 |
| Number Of Female Beneficiaries | 512 |
| Number Of Male Beneficiaries | 349 |
| Number Of Non Hispanic White Beneficiaries | 779 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 731 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 130 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 45 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.9267 |