| National Provider Identifier [NPI]: | 1316974132 |
| Last Name Of The Provider | O'DEA |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7378 YALE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BARTLETT |
| Zip Code Of The Provider | 381333604 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 5148 |
| Number Of Medicare Beneficiaries | 827 |
| Total Submitted Charge Amount | 473459 |
| Total Medicare Allowed Amount | 259592.2 |
| Total Medicare Payment Amount | 174846.18 |
| Total Medicare Standardized Payment Amount | 192125.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 74 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 215 |
| Total Drug Medicare AllowedAmount | 69.18 |
| Total Drug Medicare PaymentAmount | 34.21 |
| Total Drug Medicare Standardized Payment Amount | 34.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 5074 |
| Number Of Medicare Beneficiaries With Medical Services | 827 |
| Total Medical Submitted Charge Amount | 473244 |
| Total Medical Medicare Allowed Amount | 259523.02 |
| Total Medical Medicare Payment Amount | 174811.97 |
| Total Medical Medicare Standardized Payment Amount | 192091.18 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 368 |
| Number Of Beneficiaries Age 75 to 84 | 282 |
| Number Of Beneficiaries Age Greater 84 | 93 |
| Number Of Female Beneficiaries | 465 |
| Number Of Male Beneficiaries | 362 |
| Number Of Non Hispanic White Beneficiaries | 727 |
| Number Of Black or African American Beneficiaries | 87 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 753 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 74 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1261 |