| National Provider Identifier [NPI]: | 1306939285 |
| Last Name Of The Provider | O'HALLORAN |
| First Name Of The Provider | PHILIP |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11800 E 12 MILE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WARREN |
| Zip Code Of The Provider | 480933472 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 121 |
| Number Of Services | 3034 |
| Number Of Medicare Beneficiaries | 761 |
| Total Submitted Charge Amount | 239411 |
| Total Medicare Allowed Amount | 157388.04 |
| Total Medicare Payment Amount | 111719.05 |
| Total Medicare Standardized Payment Amount | 109305.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 24 |
| Number Of Drug Services | 634 |
| Number Of Medicare Beneficiaries With Drug Services | 192 |
| Total Drug Submitted ChargeAmount | 8425 |
| Total Drug Medicare AllowedAmount | 1369.88 |
| Total Drug Medicare PaymentAmount | 1084.98 |
| Total Drug Medicare Standardized Payment Amount | 1084.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 97 |
| Number Of Medical Services | 2400 |
| Number Of Medicare Beneficiaries With Medical Services | 761 |
| Total Medical Submitted Charge Amount | 230986 |
| Total Medical Medicare Allowed Amount | 156018.16 |
| Total Medical Medicare Payment Amount | 110634.07 |
| Total Medical Medicare Standardized Payment Amount | 108220.47 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 123 |
| Number Of Beneficiaries Age 65 to 74 | 337 |
| Number Of Beneficiaries Age 75 to 84 | 220 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 456 |
| Number Of Male Beneficiaries | 305 |
| Number Of Non Hispanic White Beneficiaries | 726 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 696 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0605 |