| National Provider Identifier [NPI]: | 1033184346 |
| Last Name Of The Provider | HACOBIAN |
| First Name Of The Provider | ASTEGHIK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 944 CALEF HWY |
| Street Address 2 Of The Provider | INTERVENTIONAL SPINE MEDICINE |
| City Of The Provider | BARRINGTON |
| Zip Code Of The Provider | 038257244 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 4315.5 |
| Number Of Medicare Beneficiaries | 401 |
| Total Submitted Charge Amount | 1045830.25 |
| Total Medicare Allowed Amount | 278034.27 |
| Total Medicare Payment Amount | 206415.01 |
| Total Medicare Standardized Payment Amount | 200670.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2091.5 |
| Number Of Medicare Beneficiaries With Drug Services | 276 |
| Total Drug Submitted ChargeAmount | 20136.75 |
| Total Drug Medicare AllowedAmount | 2102.26 |
| Total Drug Medicare PaymentAmount | 1614.12 |
| Total Drug Medicare Standardized Payment Amount | 1614.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 2224 |
| Number Of Medicare Beneficiaries With Medical Services | 401 |
| Total Medical Submitted Charge Amount | 1025693.5 |
| Total Medical Medicare Allowed Amount | 275932.01 |
| Total Medical Medicare Payment Amount | 204800.89 |
| Total Medical Medicare Standardized Payment Amount | 199056.16 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 109 |
| Number Of Beneficiaries Age 65 to 74 | 162 |
| Number Of Beneficiaries Age 75 to 84 | 91 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 251 |
| Number Of Male Beneficiaries | 150 |
| Number Of Non Hispanic White Beneficiaries | 384 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 350 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 51 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0717 |