| National Provider Identifier [NPI]: | 1205854429 |
| Last Name Of The Provider | MCKEON |
| First Name Of The Provider | SEAN |
| 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 | 114 WOODLAND ST |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061051208 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 149 |
| Number Of Services | 7480 |
| Number Of Medicare Beneficiaries | 2282 |
| Total Submitted Charge Amount | 610248.4 |
| Total Medicare Allowed Amount | 205619.35 |
| Total Medicare Payment Amount | 157008.66 |
| Total Medicare Standardized Payment Amount | 149016.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 4070 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 4746.4 |
| Total Drug Medicare AllowedAmount | 2340.34 |
| Total Drug Medicare PaymentAmount | 1811.99 |
| Total Drug Medicare Standardized Payment Amount | 1811.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 147 |
| Number Of Medical Services | 3410 |
| Number Of Medicare Beneficiaries With Medical Services | 2282 |
| Total Medical Submitted Charge Amount | 605502 |
| Total Medical Medicare Allowed Amount | 203279.01 |
| Total Medical Medicare Payment Amount | 155196.67 |
| Total Medical Medicare Standardized Payment Amount | 147204.76 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 392 |
| Number Of Beneficiaries Age 65 to 74 | 663 |
| Number Of Beneficiaries Age 75 to 84 | 706 |
| Number Of Beneficiaries Age Greater 84 | 521 |
| Number Of Female Beneficiaries | 1341 |
| Number Of Male Beneficiaries | 941 |
| Number Of Non Hispanic White Beneficiaries | 1657 |
| Number Of Black or African American Beneficiaries | 392 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 168 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1356 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 926 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.0048 |