| National Provider Identifier [NPI]: | 1962616565 |
| Last Name Of The Provider | OBEIDAT |
| First Name Of The Provider | SHADI |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 911 BYPASS RD |
| Street Address 2 Of The Provider | 8TH FLOOR CLINIC BUILDING |
| City Of The Provider | PIKEVILLE |
| Zip Code Of The Provider | 415011689 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 1161 |
| Number Of Medicare Beneficiaries | 473 |
| Total Submitted Charge Amount | 327117.72 |
| Total Medicare Allowed Amount | 130619.75 |
| Total Medicare Payment Amount | 99918.13 |
| Total Medicare Standardized Payment Amount | 105822.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 723.72 |
| Total Drug Medicare AllowedAmount | 470.56 |
| Total Drug Medicare PaymentAmount | 458.84 |
| Total Drug Medicare Standardized Payment Amount | 458.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 1135 |
| Number Of Medicare Beneficiaries With Medical Services | 473 |
| Total Medical Submitted Charge Amount | 326394 |
| Total Medical Medicare Allowed Amount | 130149.19 |
| Total Medical Medicare Payment Amount | 99459.29 |
| Total Medical Medicare Standardized Payment Amount | 105363.35 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 185 |
| Number Of Beneficiaries Age 65 to 74 | 172 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 228 |
| Number Of Male Beneficiaries | 245 |
| 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 | 272 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 201 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 73 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.2405 |