| National Provider Identifier [NPI]: | 1346290814 |
| Last Name Of The Provider | O'BRIEN |
| First Name Of The Provider | WALTER |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11600 WILSHIRE BLVD |
| Street Address 2 Of The Provider | SUITE 522 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900255781 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 7098 |
| Number Of Medicare Beneficiaries | 362 |
| Total Submitted Charge Amount | 492942 |
| Total Medicare Allowed Amount | 299536.57 |
| Total Medicare Payment Amount | 226608.84 |
| Total Medicare Standardized Payment Amount | 176624.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 548 |
| Number Of Medicare Beneficiaries With Drug Services | 82 |
| Total Drug Submitted ChargeAmount | 8392 |
| Total Drug Medicare AllowedAmount | 5910.1 |
| Total Drug Medicare PaymentAmount | 4629.4 |
| Total Drug Medicare Standardized Payment Amount | 4629.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 6550 |
| Number Of Medicare Beneficiaries With Medical Services | 362 |
| Total Medical Submitted Charge Amount | 484550 |
| Total Medical Medicare Allowed Amount | 293626.47 |
| Total Medical Medicare Payment Amount | 221979.44 |
| Total Medical Medicare Standardized Payment Amount | 171994.7 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 159 |
| Number Of Beneficiaries Age 75 to 84 | 118 |
| Number Of Beneficiaries Age Greater 84 | 65 |
| Number Of Female Beneficiaries | 219 |
| Number Of Male Beneficiaries | 143 |
| Number Of Non Hispanic White Beneficiaries | 306 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 321 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.059 |