| National Provider Identifier [NPI]: | 1982684197 |
| Last Name Of The Provider | CONNOR |
| First Name Of The Provider | CLINT |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 201 S 14TH ST |
| Street Address 2 Of The Provider | HERRIN HOSPITAL |
| City Of The Provider | HERRIN |
| Zip Code Of The Provider | 629483631 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 1427 |
| Number Of Medicare Beneficiaries | 487 |
| Total Submitted Charge Amount | 227889 |
| Total Medicare Allowed Amount | 145318.98 |
| Total Medicare Payment Amount | 111216.15 |
| Total Medicare Standardized Payment Amount | 113003.4 |
| 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 | 20 |
| Number Of Medical Services | 1427 |
| Number Of Medicare Beneficiaries With Medical Services | 487 |
| Total Medical Submitted Charge Amount | 227889 |
| Total Medical Medicare Allowed Amount | 145318.98 |
| Total Medical Medicare Payment Amount | 111216.15 |
| Total Medical Medicare Standardized Payment Amount | 113003.4 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 93 |
| Number Of Beneficiaries Age 65 to 74 | 148 |
| Number Of Beneficiaries Age 75 to 84 | 143 |
| Number Of Beneficiaries Age Greater 84 | 103 |
| Number Of Female Beneficiaries | 321 |
| Number Of Male Beneficiaries | 166 |
| Number Of Non Hispanic White Beneficiaries | 475 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 274 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 213 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 50 |
| Percent Of With Depression | 52 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.2577 |