| National Provider Identifier [NPI]: | 1134131733 |
| Last Name Of The Provider | O'BRIEN |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3260 E 104TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | THORNTON |
| Zip Code Of The Provider | 802334406 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 8392 |
| Number Of Medicare Beneficiaries | 80 |
| Total Submitted Charge Amount | 378350.47 |
| Total Medicare Allowed Amount | 190442.63 |
| Total Medicare Payment Amount | 146896.31 |
| Total Medicare Standardized Payment Amount | 146620.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 22 |
| Number Of Drug Services | 7229 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 300502.47 |
| Total Drug Medicare AllowedAmount | 154247.47 |
| Total Drug Medicare PaymentAmount | 120980.49 |
| Total Drug Medicare Standardized Payment Amount | 120980.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 1163 |
| Number Of Medicare Beneficiaries With Medical Services | 80 |
| Total Medical Submitted Charge Amount | 77848 |
| Total Medical Medicare Allowed Amount | 36195.16 |
| Total Medical Medicare Payment Amount | 25915.82 |
| Total Medical Medicare Standardized Payment Amount | 25640.44 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 40 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 53 |
| Number Of Male Beneficiaries | 27 |
| Number Of Non Hispanic White Beneficiaries | 65 |
| 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 | 64 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 41 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 29 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.079 |