| National Provider Identifier [NPI]: | 1972709087 |
| Last Name Of The Provider | O'LOUGHLIN |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6655 ALVARADO RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921205208 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 112 |
| Number Of Services | 8715 |
| Number Of Medicare Beneficiaries | 1347 |
| Total Submitted Charge Amount | 955852.38 |
| Total Medicare Allowed Amount | 304461.59 |
| Total Medicare Payment Amount | 246336.47 |
| Total Medicare Standardized Payment Amount | 207025.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 6007 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 7067 |
| Total Drug Medicare AllowedAmount | 1862.16 |
| Total Drug Medicare PaymentAmount | 1331.52 |
| Total Drug Medicare Standardized Payment Amount | 1331.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 2708 |
| Number Of Medicare Beneficiaries With Medical Services | 1347 |
| Total Medical Submitted Charge Amount | 948785.38 |
| Total Medical Medicare Allowed Amount | 302599.43 |
| Total Medical Medicare Payment Amount | 245004.95 |
| Total Medical Medicare Standardized Payment Amount | 205693.63 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 143 |
| Number Of Beneficiaries Age 65 to 74 | 793 |
| Number Of Beneficiaries Age 75 to 84 | 330 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 995 |
| Number Of Male Beneficiaries | 352 |
| Number Of Non Hispanic White Beneficiaries | 854 |
| Number Of Black or African American Beneficiaries | 69 |
| Number Of AsianPacific Islander Beneficiaries | 243 |
| Number Of Hispanic Beneficiaries | 132 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 966 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 381 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.8585 |