| National Provider Identifier [NPI]: | 1457379216 |
| Last Name Of The Provider | O'CONNELL |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2722 MERRILEE DR |
| Street Address 2 Of The Provider | SUITE 230 |
| City Of The Provider | FAIRFAX |
| Zip Code Of The Provider | 220314400 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 4905 |
| Number Of Medicare Beneficiaries | 3120 |
| Total Submitted Charge Amount | 511964.92 |
| Total Medicare Allowed Amount | 151799.61 |
| Total Medicare Payment Amount | 111503.57 |
| Total Medicare Standardized Payment Amount | 100572.82 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 284 |
| Number Of Beneficiaries Age 65 to 74 | 1232 |
| Number Of Beneficiaries Age 75 to 84 | 1035 |
| Number Of Beneficiaries Age Greater 84 | 569 |
| Number Of Female Beneficiaries | 1737 |
| Number Of Male Beneficiaries | 1383 |
| Number Of Non Hispanic White Beneficiaries | 2311 |
| Number Of Black or African American Beneficiaries | 238 |
| Number Of AsianPacific Islander Beneficiaries | 341 |
| Number Of Hispanic Beneficiaries | 143 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2568 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 552 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.5919 |