| National Provider Identifier [NPI]: | 1508960238 |
| Last Name Of The Provider | TESI |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 116 N VALE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | JEFFERSON |
| Zip Code Of The Provider | 756572256 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 2549 |
| Number Of Medicare Beneficiaries | 956 |
| Total Submitted Charge Amount | 196642.6 |
| Total Medicare Allowed Amount | 108245.96 |
| Total Medicare Payment Amount | 81358.55 |
| Total Medicare Standardized Payment Amount | 85605.77 |
| 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 | 28 |
| Number Of Medical Services | 2549 |
| Number Of Medicare Beneficiaries With Medical Services | 956 |
| Total Medical Submitted Charge Amount | 196642.6 |
| Total Medical Medicare Allowed Amount | 108245.96 |
| Total Medical Medicare Payment Amount | 81358.55 |
| Total Medical Medicare Standardized Payment Amount | 85605.77 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 97 |
| Number Of Beneficiaries Age 65 to 74 | 182 |
| Number Of Beneficiaries Age 75 to 84 | 296 |
| Number Of Beneficiaries Age Greater 84 | 381 |
| Number Of Female Beneficiaries | 617 |
| Number Of Male Beneficiaries | 339 |
| Number Of Non Hispanic White Beneficiaries | 756 |
| Number Of Black or African American Beneficiaries | 184 |
| 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 | 309 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 647 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 73 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 28 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.0475 |