| National Provider Identifier [NPI]: | 1518960640 |
| Last Name Of The Provider | OBI |
| First Name Of The Provider | EMMANUEL |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1215 E COLLEGE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROWNSVILLE |
| Zip Code Of The Provider | 380121656 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 7562 |
| Number Of Medicare Beneficiaries | 923 |
| Total Submitted Charge Amount | 754468 |
| Total Medicare Allowed Amount | 408486.61 |
| Total Medicare Payment Amount | 300147.31 |
| Total Medicare Standardized Payment Amount | 325440.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 2160 |
| Number Of Medicare Beneficiaries With Drug Services | 133 |
| Total Drug Submitted ChargeAmount | 16638 |
| Total Drug Medicare AllowedAmount | 1273.38 |
| Total Drug Medicare PaymentAmount | 1083.95 |
| Total Drug Medicare Standardized Payment Amount | 1083.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 5402 |
| Number Of Medicare Beneficiaries With Medical Services | 923 |
| Total Medical Submitted Charge Amount | 737830 |
| Total Medical Medicare Allowed Amount | 407213.23 |
| Total Medical Medicare Payment Amount | 299063.36 |
| Total Medical Medicare Standardized Payment Amount | 324356.09 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 250 |
| Number Of Beneficiaries Age 65 to 74 | 317 |
| Number Of Beneficiaries Age 75 to 84 | 238 |
| Number Of Beneficiaries Age Greater 84 | 118 |
| Number Of Female Beneficiaries | 560 |
| Number Of Male Beneficiaries | 363 |
| Number Of Non Hispanic White Beneficiaries | 469 |
| Number Of Black or African American Beneficiaries | 440 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 469 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 454 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.1114 |