| National Provider Identifier [NPI]: | 1982617072 |
| Last Name Of The Provider | CONNELLY |
| First Name Of The Provider | TERENCE |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3340 TAMIAMI TRL |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORT CHARLOTTE |
| Zip Code Of The Provider | 339528088 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 121 |
| Number Of Services | 18900 |
| Number Of Medicare Beneficiaries | 1943 |
| Total Submitted Charge Amount | 1506314.64 |
| Total Medicare Allowed Amount | 1355871.49 |
| Total Medicare Payment Amount | 1034781.83 |
| Total Medicare Standardized Payment Amount | 1068656.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 10257 |
| Number Of Medicare Beneficiaries With Drug Services | 224 |
| Total Drug Submitted ChargeAmount | 41097.86 |
| Total Drug Medicare AllowedAmount | 40237.09 |
| Total Drug Medicare PaymentAmount | 31519.44 |
| Total Drug Medicare Standardized Payment Amount | 31519.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 117 |
| Number Of Medical Services | 8643 |
| Number Of Medicare Beneficiaries With Medical Services | 1943 |
| Total Medical Submitted Charge Amount | 1465216.78 |
| Total Medical Medicare Allowed Amount | 1315634.4 |
| Total Medical Medicare Payment Amount | 1003262.39 |
| Total Medical Medicare Standardized Payment Amount | 1037137.39 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 101 |
| Number Of Beneficiaries Age 65 to 74 | 630 |
| Number Of Beneficiaries Age 75 to 84 | 790 |
| Number Of Beneficiaries Age Greater 84 | 422 |
| Number Of Female Beneficiaries | 846 |
| Number Of Male Beneficiaries | 1097 |
| Number Of Non Hispanic White Beneficiaries | 1815 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1763 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 180 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7074 |