| National Provider Identifier [NPI]: | 1083639397 |
| Last Name Of The Provider | O'BRIEN |
| First Name Of The Provider | PATRICK |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1221 NICOLLET MALL |
| Street Address 2 Of The Provider | SUITE 600 |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554032420 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 152 |
| Number Of Services | 5645 |
| Number Of Medicare Beneficiaries | 2084 |
| Total Submitted Charge Amount | 292034.25 |
| Total Medicare Allowed Amount | 98998.54 |
| Total Medicare Payment Amount | 75387.01 |
| Total Medicare Standardized Payment Amount | 77226.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1896 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 1973 |
| Total Drug Medicare AllowedAmount | 398.24 |
| Total Drug Medicare PaymentAmount | 312.16 |
| Total Drug Medicare Standardized Payment Amount | 312.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 150 |
| Number Of Medical Services | 3749 |
| Number Of Medicare Beneficiaries With Medical Services | 2084 |
| Total Medical Submitted Charge Amount | 290061.25 |
| Total Medical Medicare Allowed Amount | 98600.3 |
| Total Medical Medicare Payment Amount | 75074.85 |
| Total Medical Medicare Standardized Payment Amount | 76914.07 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 466 |
| Number Of Beneficiaries Age 65 to 74 | 667 |
| Number Of Beneficiaries Age 75 to 84 | 637 |
| Number Of Beneficiaries Age Greater 84 | 314 |
| Number Of Female Beneficiaries | 1379 |
| Number Of Male Beneficiaries | 705 |
| Number Of Non Hispanic White Beneficiaries | 1970 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1586 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 498 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2123 |