| National Provider Identifier [NPI]: | 1396700803 |
| Last Name Of The Provider | O'BRIEN |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1121 N CENTRAL AVE |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | KISSIMMEE |
| Zip Code Of The Provider | 347414405 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 3733 |
| Number Of Medicare Beneficiaries | 1148 |
| Total Submitted Charge Amount | 629243.03 |
| Total Medicare Allowed Amount | 298531.08 |
| Total Medicare Payment Amount | 220003.76 |
| Total Medicare Standardized Payment Amount | 224490.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 292 |
| Number Of Medicare Beneficiaries With Drug Services | 64 |
| Total Drug Submitted ChargeAmount | 8927.4 |
| Total Drug Medicare AllowedAmount | 825.32 |
| Total Drug Medicare PaymentAmount | 678.69 |
| Total Drug Medicare Standardized Payment Amount | 678.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 3441 |
| Number Of Medicare Beneficiaries With Medical Services | 1148 |
| Total Medical Submitted Charge Amount | 620315.63 |
| Total Medical Medicare Allowed Amount | 297705.76 |
| Total Medical Medicare Payment Amount | 219325.07 |
| Total Medical Medicare Standardized Payment Amount | 223811.55 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 179 |
| Number Of Beneficiaries Age 65 to 74 | 470 |
| Number Of Beneficiaries Age 75 to 84 | 373 |
| Number Of Beneficiaries Age Greater 84 | 126 |
| Number Of Female Beneficiaries | 610 |
| Number Of Male Beneficiaries | 538 |
| Number Of Non Hispanic White Beneficiaries | 852 |
| Number Of Black or African American Beneficiaries | 65 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 206 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 896 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 252 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 25 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 59 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.1838 |