| National Provider Identifier [NPI]: | 1295850436 |
| Last Name Of The Provider | OTHEE |
| First Name Of The Provider | MANDEEP |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 519 N LINCOLN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ODESSA |
| Zip Code Of The Provider | 797614429 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 3273 |
| Number Of Medicare Beneficiaries | 572 |
| Total Submitted Charge Amount | 754685.63 |
| Total Medicare Allowed Amount | 211102.15 |
| Total Medicare Payment Amount | 158449.65 |
| Total Medicare Standardized Payment Amount | 161060.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 232 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 2773 |
| Total Drug Medicare AllowedAmount | 561.61 |
| Total Drug Medicare PaymentAmount | 29.68 |
| Total Drug Medicare Standardized Payment Amount | 29.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 3041 |
| Number Of Medicare Beneficiaries With Medical Services | 572 |
| Total Medical Submitted Charge Amount | 751912.63 |
| Total Medical Medicare Allowed Amount | 210540.54 |
| Total Medical Medicare Payment Amount | 158419.97 |
| Total Medical Medicare Standardized Payment Amount | 161030.35 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 102 |
| Number Of Beneficiaries Age 65 to 74 | 194 |
| Number Of Beneficiaries Age 75 to 84 | 195 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 356 |
| Number Of Male Beneficiaries | 216 |
| Number Of Non Hispanic White Beneficiaries | 358 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 182 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 393 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 179 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.3113 |