| National Provider Identifier [NPI]: | 1881670750 |
| Last Name Of The Provider | O'LOUGHLIN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 85 SEYMOUR ST |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | HARTFORD |
| Zip Code Of The Provider | 061065501 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 169 |
| Number Of Services | 10132 |
| Number Of Medicare Beneficiaries | 3600 |
| Total Submitted Charge Amount | 1103920 |
| Total Medicare Allowed Amount | 262448.86 |
| Total Medicare Payment Amount | 207062.33 |
| Total Medicare Standardized Payment Amount | 196373.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 4241 |
| Number Of Medicare Beneficiaries With Drug Services | 71 |
| Total Drug Submitted ChargeAmount | 17493 |
| Total Drug Medicare AllowedAmount | 2113.17 |
| Total Drug Medicare PaymentAmount | 1656.72 |
| Total Drug Medicare Standardized Payment Amount | 1656.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 165 |
| Number Of Medical Services | 5891 |
| Number Of Medicare Beneficiaries With Medical Services | 3600 |
| Total Medical Submitted Charge Amount | 1086427 |
| Total Medical Medicare Allowed Amount | 260335.69 |
| Total Medical Medicare Payment Amount | 205405.61 |
| Total Medical Medicare Standardized Payment Amount | 194716.64 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 658 |
| Number Of Beneficiaries Age 65 to 74 | 1104 |
| Number Of Beneficiaries Age 75 to 84 | 1060 |
| Number Of Beneficiaries Age Greater 84 | 778 |
| Number Of Female Beneficiaries | 2030 |
| Number Of Male Beneficiaries | 1570 |
| Number Of Non Hispanic White Beneficiaries | 2858 |
| Number Of Black or African American Beneficiaries | 290 |
| Number Of AsianPacific Islander Beneficiaries | 48 |
| Number Of Hispanic Beneficiaries | 346 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 58 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2200 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1400 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0695 |