| National Provider Identifier [NPI]: | 1346272408 |
| Last Name Of The Provider | GHADISHAH |
| First Name Of The Provider | BABAK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 201 N BUFFALO DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891450373 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Osteopathic Manipulative Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 4921 |
| Number Of Medicare Beneficiaries | 319 |
| Total Submitted Charge Amount | 463210 |
| Total Medicare Allowed Amount | 217885.52 |
| Total Medicare Payment Amount | 156109.27 |
| Total Medicare Standardized Payment Amount | 152202.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 1726 |
| Number Of Medicare Beneficiaries With Drug Services | 169 |
| Total Drug Submitted ChargeAmount | 17748 |
| Total Drug Medicare AllowedAmount | 3238.52 |
| Total Drug Medicare PaymentAmount | 2341.23 |
| Total Drug Medicare Standardized Payment Amount | 2341.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 3195 |
| Number Of Medicare Beneficiaries With Medical Services | 319 |
| Total Medical Submitted Charge Amount | 445462 |
| Total Medical Medicare Allowed Amount | 214647 |
| Total Medical Medicare Payment Amount | 153768.04 |
| Total Medical Medicare Standardized Payment Amount | 149861.7 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 155 |
| Number Of Beneficiaries Age 75 to 84 | 98 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 180 |
| Number Of Male Beneficiaries | 139 |
| Number Of Non Hispanic White Beneficiaries | 250 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 271 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1622 |