| National Provider Identifier [NPI]: | 1457315624 |
| Last Name Of The Provider | TIERNEY |
| First Name Of The Provider | SEAN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19001 OLD LAGRANGE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOKENA |
| Zip Code Of The Provider | 604488012 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiac Electrophysiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 9896 |
| Number Of Medicare Beneficiaries | 2370 |
| Total Submitted Charge Amount | 1953973 |
| Total Medicare Allowed Amount | 745797.02 |
| Total Medicare Payment Amount | 550980.4 |
| Total Medicare Standardized Payment Amount | 512579.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 140 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 14000 |
| Total Drug Medicare AllowedAmount | 7396.03 |
| Total Drug Medicare PaymentAmount | 5798.41 |
| Total Drug Medicare Standardized Payment Amount | 5798.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 9756 |
| Number Of Medicare Beneficiaries With Medical Services | 2370 |
| Total Medical Submitted Charge Amount | 1939973 |
| Total Medical Medicare Allowed Amount | 738400.99 |
| Total Medical Medicare Payment Amount | 545181.99 |
| Total Medical Medicare Standardized Payment Amount | 506780.74 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 229 |
| Number Of Beneficiaries Age 65 to 74 | 740 |
| Number Of Beneficiaries Age 75 to 84 | 876 |
| Number Of Beneficiaries Age Greater 84 | 525 |
| Number Of Female Beneficiaries | 1160 |
| Number Of Male Beneficiaries | 1210 |
| Number Of Non Hispanic White Beneficiaries | 1656 |
| Number Of Black or African American Beneficiaries | 614 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 77 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1902 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 468 |
| Percent Of With Atrial Fibrillation | 46 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 62 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0559 |