Medicare Facts for Dr. Dominic Connolly, MD


National Provider Identifier [NPI]: 1093754269
Last Name Of The Provider CONNOLLY
First Name Of The Provider DOMINIC
Middle Initial Of The Provider
Credentials Of The Provider M.D.
Gender Of The Provider M
Entity Type Of The Provider I
Street Address 1 Of The Provider 12040 NE 128TH ST
Street Address 2 Of The Provider
City Of The Provider KIRKLAND
Zip Code Of The Provider 980343013
State Code Of The Provider WA
Country Code Of The Provider US
Provider Type Of The Provider Emergency Medicine
Medicare Participation Indicator Y
Number Of HCPCS 34
Number Of Services 653
Number Of Medicare Beneficiaries 371
Total Submitted Charge Amount 259480
Total Medicare Allowed Amount 67460.08
Total Medicare Payment Amount 51295.44
Total Medicare Standardized Payment Amount 50104.92
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 34
Number Of Medical Services 653
Number Of Medicare Beneficiaries With Medical Services 371
Total Medical Submitted Charge Amount 259480
Total Medical Medicare Allowed Amount 67460.08
Total Medical Medicare Payment Amount 51295.44
Total Medical Medicare Standardized Payment Amount 50104.92
Average Age Of Beneficiaries 77
Number Of Beneficiaries Age Less65 49
Number Of Beneficiaries Age 65 to 74 83
Number Of Beneficiaries Age 75 to 84 118
Number Of Beneficiaries Age Greater 84 121
Number Of Female Beneficiaries 234
Number Of Male Beneficiaries 137
Number Of Non Hispanic White Beneficiaries 324
Number Of Black or African American Beneficiaries
Number Of AsianPacific Islander Beneficiaries 25
Number Of Hispanic Beneficiaries
Number Of American Indian Alaska Native Beneficiaries 0
Number Of Beneficiaries With Race Not Else where Classified
Number Of Beneficiaries With Medicare Only Entitlement 282
Number Of Beneficiaries With Medicare Medicaid Entitlement 89
Percent Of With Atrial Fibrillation 18
Percent Of With Alzheimers Disease or Dementia 30
Percent Of With Asthma 10
Percent Of With Cancer 13
Percent Of With Heart Failure 34
Percent Of With Chronic Kidney Disease 41
Percent Of With Chronic Obstructive Pulmonary Disease 18
Percent Of With Depression 35
Percent Of With Diabetes 26
Percent Of With Hyperlipidemia 50
Percent Of With Hypertension 73
Percent Of With Ischemic Heart Disease 42
Percent Of With Osteoporosis 11
Percent Of With Rheumatoid Arthritis Osteoarthritis 39
Percent Of With Schizophrenia Other PsychoticDisorders 11
Percent Of With Stroke 7
Average HCC Risk Score Of Beneficiaries 1.7125

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