| National Provider Identifier [NPI]: | 1922101294 |
| Last Name Of The Provider | O'HALLORAN |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MB BCH BAO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | BETH ISRAEL DEACONESS MEDICAL CENTER, 1 DEACONESS ROAD |
| Street Address 2 Of The Provider | DIVISION OF CARDIOLOGY |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 02215 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 3160 |
| Number Of Medicare Beneficiaries | 1555 |
| Total Submitted Charge Amount | 576916 |
| Total Medicare Allowed Amount | 184709.45 |
| Total Medicare Payment Amount | 138188.25 |
| Total Medicare Standardized Payment Amount | 133414.54 |
| 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 | 38 |
| Number Of Medical Services | 3160 |
| Number Of Medicare Beneficiaries With Medical Services | 1555 |
| Total Medical Submitted Charge Amount | 576916 |
| Total Medical Medicare Allowed Amount | 184709.45 |
| Total Medical Medicare Payment Amount | 138188.25 |
| Total Medical Medicare Standardized Payment Amount | 133414.54 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 224 |
| Number Of Beneficiaries Age 65 to 74 | 511 |
| Number Of Beneficiaries Age 75 to 84 | 505 |
| Number Of Beneficiaries Age Greater 84 | 315 |
| Number Of Female Beneficiaries | 766 |
| Number Of Male Beneficiaries | 789 |
| Number Of Non Hispanic White Beneficiaries | 1234 |
| Number Of Black or African American Beneficiaries | 182 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | 69 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1115 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 440 |
| Percent Of With Atrial Fibrillation | 34 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 55 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.112 |