| National Provider Identifier [NPI]: | 1396798153 |
| Last Name Of The Provider | CONNOLLY |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6624 FANNIN ST |
| Street Address 2 Of The Provider | SUITE 1730 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770302312 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 5856 |
| Number Of Medicare Beneficiaries | 1244 |
| Total Submitted Charge Amount | 1160322.3 |
| Total Medicare Allowed Amount | 483976.26 |
| Total Medicare Payment Amount | 370067.05 |
| Total Medicare Standardized Payment Amount | 376685.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 242 |
| Number Of Medicare Beneficiaries With Drug Services | 63 |
| Total Drug Submitted ChargeAmount | 8917.3 |
| Total Drug Medicare AllowedAmount | 7358.57 |
| Total Drug Medicare PaymentAmount | 6251.06 |
| Total Drug Medicare Standardized Payment Amount | 6251.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 5614 |
| Number Of Medicare Beneficiaries With Medical Services | 1244 |
| Total Medical Submitted Charge Amount | 1151405 |
| Total Medical Medicare Allowed Amount | 476617.69 |
| Total Medical Medicare Payment Amount | 363815.99 |
| Total Medical Medicare Standardized Payment Amount | 370434.34 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 181 |
| Number Of Beneficiaries Age 65 to 74 | 514 |
| Number Of Beneficiaries Age 75 to 84 | 376 |
| Number Of Beneficiaries Age Greater 84 | 173 |
| Number Of Female Beneficiaries | 652 |
| Number Of Male Beneficiaries | 592 |
| Number Of Non Hispanic White Beneficiaries | 885 |
| Number Of Black or African American Beneficiaries | 212 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 113 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1030 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 214 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 59 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 47 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.6388 |