| National Provider Identifier [NPI]: | 1790744696 |
| Last Name Of The Provider | O'BRIEN |
| First Name Of The Provider | LINDA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3333 SILAS CREEK PKWY |
| Street Address 2 Of The Provider | ATTN: IPOF |
| City Of The Provider | WINSTON-SALEM |
| Zip Code Of The Provider | 271033013 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 389 |
| Number Of Medicare Beneficiaries | 366 |
| Total Submitted Charge Amount | 175577 |
| Total Medicare Allowed Amount | 73502.84 |
| Total Medicare Payment Amount | 55863.39 |
| Total Medicare Standardized Payment Amount | 57949.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 389 |
| Number Of Medicare Beneficiaries With Medical Services | 366 |
| Total Medical Submitted Charge Amount | 175577 |
| Total Medical Medicare Allowed Amount | 73502.84 |
| Total Medical Medicare Payment Amount | 55863.39 |
| Total Medical Medicare Standardized Payment Amount | 57949.07 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 103 |
| Number Of Beneficiaries Age 75 to 84 | 107 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 218 |
| Number Of Male Beneficiaries | 148 |
| Number Of Non Hispanic White Beneficiaries | 332 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 236 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 130 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 45 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.0558 |