| National Provider Identifier [NPI]: | 1417021940 |
| Last Name Of The Provider | O'BRIEN |
| First Name Of The Provider | MICHAEL |
| 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 | 618 TOLL GATE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WARWICK |
| Zip Code Of The Provider | 028862717 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 6960 |
| Number Of Medicare Beneficiaries | 866 |
| Total Submitted Charge Amount | 1283345 |
| Total Medicare Allowed Amount | 645317.35 |
| Total Medicare Payment Amount | 481830.41 |
| Total Medicare Standardized Payment Amount | 473542.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 213 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 283600 |
| Total Drug Medicare AllowedAmount | 191668.02 |
| Total Drug Medicare PaymentAmount | 150179.84 |
| Total Drug Medicare Standardized Payment Amount | 150179.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 6747 |
| Number Of Medicare Beneficiaries With Medical Services | 866 |
| Total Medical Submitted Charge Amount | 999745 |
| Total Medical Medicare Allowed Amount | 453649.33 |
| Total Medical Medicare Payment Amount | 331650.57 |
| Total Medical Medicare Standardized Payment Amount | 323363.13 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 321 |
| Number Of Beneficiaries Age 75 to 84 | 255 |
| Number Of Beneficiaries Age Greater 84 | 211 |
| Number Of Female Beneficiaries | 539 |
| Number Of Male Beneficiaries | 327 |
| Number Of Non Hispanic White Beneficiaries | 780 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 670 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 196 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5045 |