| National Provider Identifier [NPI]: | 1316010192 |
| Last Name Of The Provider | CONLEY |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 315 W PONCE DE LEON AVE |
| Street Address 2 Of The Provider | SUITE 360 |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 30030 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 2676 |
| Number Of Medicare Beneficiaries | 517 |
| Total Submitted Charge Amount | 348085.93 |
| Total Medicare Allowed Amount | 232296.27 |
| Total Medicare Payment Amount | 167614.87 |
| Total Medicare Standardized Payment Amount | 169478.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 85 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 3515 |
| Total Drug Medicare AllowedAmount | 1110.5 |
| Total Drug Medicare PaymentAmount | 725.85 |
| Total Drug Medicare Standardized Payment Amount | 725.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 2591 |
| Number Of Medicare Beneficiaries With Medical Services | 517 |
| Total Medical Submitted Charge Amount | 344570.93 |
| Total Medical Medicare Allowed Amount | 231185.77 |
| Total Medical Medicare Payment Amount | 166889.02 |
| Total Medical Medicare Standardized Payment Amount | 168752.93 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 289 |
| Number Of Beneficiaries Age 65 to 74 | 137 |
| Number Of Beneficiaries Age 75 to 84 | 61 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 283 |
| Number Of Male Beneficiaries | 234 |
| Number Of Non Hispanic White Beneficiaries | 196 |
| Number Of Black or African American Beneficiaries | 299 |
| 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 | 149 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 368 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 37 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 3 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 69 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 55 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8391 |