| National Provider Identifier [NPI]: | 1205813128 |
| Last Name Of The Provider | CANNON |
| First Name Of The Provider | KEITH |
| 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 | 13400 E SHEA BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SCOTTSDALE |
| Zip Code Of The Provider | 852595404 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 551 |
| Number Of Medicare Beneficiaries | 241 |
| Total Submitted Charge Amount | 70104.81 |
| Total Medicare Allowed Amount | 60249.31 |
| Total Medicare Payment Amount | 45818.42 |
| Total Medicare Standardized Payment Amount | 49359.3 |
| 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 | 23 |
| Number Of Medical Services | 551 |
| Number Of Medicare Beneficiaries With Medical Services | 241 |
| Total Medical Submitted Charge Amount | 70104.81 |
| Total Medical Medicare Allowed Amount | 60249.31 |
| Total Medical Medicare Payment Amount | 45818.42 |
| Total Medical Medicare Standardized Payment Amount | 49359.3 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 78 |
| Number Of Beneficiaries Age 75 to 84 | 78 |
| Number Of Beneficiaries Age Greater 84 | 63 |
| Number Of Female Beneficiaries | 110 |
| Number Of Male Beneficiaries | 131 |
| Number Of Non Hispanic White Beneficiaries | 224 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 224 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 30 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.3762 |