| National Provider Identifier [NPI]: | 1982898631 |
| Last Name Of The Provider | O'BRIEN |
| First Name Of The Provider | KELLY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1701 SUNSET BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770051713 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 1810 |
| Number Of Medicare Beneficiaries | 498 |
| Total Submitted Charge Amount | 124922.77 |
| Total Medicare Allowed Amount | 124537.85 |
| Total Medicare Payment Amount | 82538.81 |
| Total Medicare Standardized Payment Amount | 82991.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 196 |
| Number Of Medicare Beneficiaries With Drug Services | 107 |
| Total Drug Submitted ChargeAmount | 3630.98 |
| Total Drug Medicare AllowedAmount | 3628 |
| Total Drug Medicare PaymentAmount | 3501.31 |
| Total Drug Medicare Standardized Payment Amount | 3501.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 1614 |
| Number Of Medicare Beneficiaries With Medical Services | 498 |
| Total Medical Submitted Charge Amount | 121291.79 |
| Total Medical Medicare Allowed Amount | 120909.85 |
| Total Medical Medicare Payment Amount | 79037.5 |
| Total Medical Medicare Standardized Payment Amount | 79489.8 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 236 |
| Number Of Beneficiaries Age 75 to 84 | 165 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 416 |
| Number Of Male Beneficiaries | 82 |
| Number Of Non Hispanic White Beneficiaries | 433 |
| Number Of Black or African American Beneficiaries | 30 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 479 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8148 |