| National Provider Identifier [NPI]: | 1700867413 |
| Last Name Of The Provider | BABUS |
| First Name Of The Provider | GLENN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1099 TARGEE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | STATEN ISLAND |
| Zip Code Of The Provider | 103044310 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 13803 |
| Number Of Medicare Beneficiaries | 709 |
| Total Submitted Charge Amount | 1732717.75 |
| Total Medicare Allowed Amount | 603577.05 |
| Total Medicare Payment Amount | 491921.69 |
| Total Medicare Standardized Payment Amount | 385596.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 1618 |
| Number Of Medicare Beneficiaries With Drug Services | 178 |
| Total Drug Submitted ChargeAmount | 86045 |
| Total Drug Medicare AllowedAmount | 9969.93 |
| Total Drug Medicare PaymentAmount | 7809.3 |
| Total Drug Medicare Standardized Payment Amount | 7809.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 12185 |
| Number Of Medicare Beneficiaries With Medical Services | 709 |
| Total Medical Submitted Charge Amount | 1646672.75 |
| Total Medical Medicare Allowed Amount | 593607.12 |
| Total Medical Medicare Payment Amount | 484112.39 |
| Total Medical Medicare Standardized Payment Amount | 377787.05 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 300 |
| Number Of Beneficiaries Age 65 to 74 | 243 |
| Number Of Beneficiaries Age 75 to 84 | 117 |
| Number Of Beneficiaries Age Greater 84 | 49 |
| Number Of Female Beneficiaries | 401 |
| Number Of Male Beneficiaries | 308 |
| Number Of Non Hispanic White Beneficiaries | 557 |
| Number Of Black or African American Beneficiaries | 58 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 60 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 494 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 215 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3463 |