| National Provider Identifier [NPI]: | 1932158193 |
| Last Name Of The Provider | CONN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 505 WABASH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MARION |
| Zip Code Of The Provider | 46952 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 3524 |
| Number Of Medicare Beneficiaries | 523 |
| Total Submitted Charge Amount | 270757.9 |
| Total Medicare Allowed Amount | 198036.76 |
| Total Medicare Payment Amount | 143859.76 |
| Total Medicare Standardized Payment Amount | 172510.45 |
| 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 | 17 |
| Number Of Medical Services | 3524 |
| Number Of Medicare Beneficiaries With Medical Services | 523 |
| Total Medical Submitted Charge Amount | 270757.9 |
| Total Medical Medicare Allowed Amount | 198036.76 |
| Total Medical Medicare Payment Amount | 143859.76 |
| Total Medical Medicare Standardized Payment Amount | 172510.45 |
| Average Age Of Beneficiaries | 51 |
| Number Of Beneficiaries Age Less65 | 452 |
| Number Of Beneficiaries Age 65 to 74 | 52 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 265 |
| Number Of Male Beneficiaries | 258 |
| Number Of Non Hispanic White Beneficiaries | 456 |
| Number Of Black or African American Beneficiaries | 48 |
| 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 | 77 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 446 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 58 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 43 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2567 |