| National Provider Identifier [NPI]: | 1487629341 |
| Last Name Of The Provider | HEANEY |
| First Name Of The Provider | CONOR |
| 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 | 124 W PITKIN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PUEBLO |
| Zip Code Of The Provider | 810042021 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 231 |
| Number Of Services | 8122 |
| Number Of Medicare Beneficiaries | 4531 |
| Total Submitted Charge Amount | 835455.5 |
| Total Medicare Allowed Amount | 245035.26 |
| Total Medicare Payment Amount | 183572.69 |
| Total Medicare Standardized Payment Amount | 185877.8 |
| 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 | 231 |
| Number Of Medical Services | 8122 |
| Number Of Medicare Beneficiaries With Medical Services | 4531 |
| Total Medical Submitted Charge Amount | 835455.5 |
| Total Medical Medicare Allowed Amount | 245035.26 |
| Total Medical Medicare Payment Amount | 183572.69 |
| Total Medical Medicare Standardized Payment Amount | 185877.8 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 870 |
| Number Of Beneficiaries Age 65 to 74 | 1694 |
| Number Of Beneficiaries Age 75 to 84 | 1299 |
| Number Of Beneficiaries Age Greater 84 | 668 |
| Number Of Female Beneficiaries | 2914 |
| Number Of Male Beneficiaries | 1617 |
| Number Of Non Hispanic White Beneficiaries | 3632 |
| Number Of Black or African American Beneficiaries | 46 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 791 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3320 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1211 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3404 |