| National Provider Identifier [NPI]: | 1003976630 |
| Last Name Of The Provider | NOBES |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 32 MALLETTS BAY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WINOOSKI |
| Zip Code Of The Provider | 054041959 |
| State Code Of The Provider | VT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 771 |
| Number Of Medicare Beneficiaries | 121 |
| Total Submitted Charge Amount | 63423.5 |
| Total Medicare Allowed Amount | 37152.52 |
| Total Medicare Payment Amount | 26919.31 |
| Total Medicare Standardized Payment Amount | 32323.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 36 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 536 |
| Total Drug Medicare AllowedAmount | 281.11 |
| Total Drug Medicare PaymentAmount | 272.24 |
| Total Drug Medicare Standardized Payment Amount | 272.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 735 |
| Number Of Medicare Beneficiaries With Medical Services | 121 |
| Total Medical Submitted Charge Amount | 62887.5 |
| Total Medical Medicare Allowed Amount | 36871.41 |
| Total Medical Medicare Payment Amount | 26647.07 |
| Total Medical Medicare Standardized Payment Amount | 32051.07 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 43 |
| Number Of Beneficiaries Age 75 to 84 | 17 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 76 |
| Number Of Male Beneficiaries | 45 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 60 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 61 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 1.0666 |