National Provider Identifier [NPI]: |
1497744247 |
Last Name Of The Provider |
O'BRIEN |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3156 VISTA WAY |
Street Address 2 Of The Provider |
SUITE 405 |
City Of The Provider |
OCEANSIDE |
Zip Code Of The Provider |
920563622 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1761 |
Number Of Medicare Beneficiaries |
559 |
Total Submitted Charge Amount |
317141.77 |
Total Medicare Allowed Amount |
180500.57 |
Total Medicare Payment Amount |
141042.29 |
Total Medicare Standardized Payment Amount |
137837.23 |
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 |
22 |
Number Of Medical Services |
1761 |
Number Of Medicare Beneficiaries With Medical Services |
559 |
Total Medical Submitted Charge Amount |
317141.77 |
Total Medical Medicare Allowed Amount |
180500.57 |
Total Medical Medicare Payment Amount |
141042.29 |
Total Medical Medicare Standardized Payment Amount |
137837.23 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
109 |
Number Of Beneficiaries Age 75 to 84 |
174 |
Number Of Beneficiaries Age Greater 84 |
195 |
Number Of Female Beneficiaries |
324 |
Number Of Male Beneficiaries |
235 |
Number Of Non Hispanic White Beneficiaries |
458 |
Number Of Black or African American Beneficiaries |
18 |
Number Of AsianPacific Islander Beneficiaries |
25 |
Number Of Hispanic Beneficiaries |
45 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
422 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
137 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.9106 |