| National Provider Identifier [NPI]: | 1336121565 |
| Last Name Of The Provider | O'LEARY |
| First Name Of The Provider | JACQUELINE |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD, MPH |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3410 WORTH ST |
| Street Address 2 Of The Provider | SUITE 860 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752462003 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 859 |
| Number Of Medicare Beneficiaries | 248 |
| Total Submitted Charge Amount | 158765.94 |
| Total Medicare Allowed Amount | 75254.58 |
| Total Medicare Payment Amount | 55078.85 |
| Total Medicare Standardized Payment Amount | 57621.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 168 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 23000 |
| Total Drug Medicare AllowedAmount | 8653.55 |
| Total Drug Medicare PaymentAmount | 6616.76 |
| Total Drug Medicare Standardized Payment Amount | 6616.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 691 |
| Number Of Medicare Beneficiaries With Medical Services | 248 |
| Total Medical Submitted Charge Amount | 135765.94 |
| Total Medical Medicare Allowed Amount | 66601.03 |
| Total Medical Medicare Payment Amount | 48462.09 |
| Total Medical Medicare Standardized Payment Amount | 51004.48 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 105 |
| Number Of Beneficiaries Age 65 to 74 | 106 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 137 |
| Number Of Male Beneficiaries | 111 |
| Number Of Non Hispanic White Beneficiaries | 174 |
| Number Of Black or African American Beneficiaries | 33 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 187 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 61 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.2584 |