| National Provider Identifier [NPI]: | 1558397471 |
| Last Name Of The Provider | KONECKE |
| First Name Of The Provider | RON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 190 WELLES ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORTY FORT |
| Zip Code Of The Provider | 187044968 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 147 |
| Number Of Services | 5447 |
| Number Of Medicare Beneficiaries | 3194 |
| Total Submitted Charge Amount | 518730 |
| Total Medicare Allowed Amount | 157387.46 |
| Total Medicare Payment Amount | 118294.25 |
| Total Medicare Standardized Payment Amount | 122351.26 |
| 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 | 147 |
| Number Of Medical Services | 5447 |
| Number Of Medicare Beneficiaries With Medical Services | 3194 |
| Total Medical Submitted Charge Amount | 518730 |
| Total Medical Medicare Allowed Amount | 157387.46 |
| Total Medical Medicare Payment Amount | 118294.25 |
| Total Medical Medicare Standardized Payment Amount | 122351.26 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 347 |
| Number Of Beneficiaries Age 65 to 74 | 1379 |
| Number Of Beneficiaries Age 75 to 84 | 1028 |
| Number Of Beneficiaries Age Greater 84 | 440 |
| Number Of Female Beneficiaries | 2204 |
| Number Of Male Beneficiaries | 990 |
| Number Of Non Hispanic White Beneficiaries | 3105 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2699 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 495 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1632 |