| National Provider Identifier [NPI]: | 1356577787 |
| Last Name Of The Provider | OBESSO |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 120 E CHARNWOOD ST |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 757011708 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Sleep Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 1444 |
| Number Of Medicare Beneficiaries | 593 |
| Total Submitted Charge Amount | 842505 |
| Total Medicare Allowed Amount | 137002.19 |
| Total Medicare Payment Amount | 100146.72 |
| Total Medicare Standardized Payment Amount | 104545.38 |
| 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 | 8 |
| Number Of Medical Services | 1444 |
| Number Of Medicare Beneficiaries With Medical Services | 593 |
| Total Medical Submitted Charge Amount | 842505 |
| Total Medical Medicare Allowed Amount | 137002.19 |
| Total Medical Medicare Payment Amount | 100146.72 |
| Total Medical Medicare Standardized Payment Amount | 104545.38 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 102 |
| Number Of Beneficiaries Age 65 to 74 | 319 |
| Number Of Beneficiaries Age 75 to 84 | 146 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 247 |
| Number Of Male Beneficiaries | 346 |
| Number Of Non Hispanic White Beneficiaries | 514 |
| Number Of Black or African American Beneficiaries | 53 |
| 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 | 512 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.1487 |