| National Provider Identifier [NPI]: | 1487754974 |
| Last Name Of The Provider | BAHNASSI |
| First Name Of The Provider | AMJAD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 40 WRIGHT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PALMER |
| Zip Code Of The Provider | 010691138 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 3 |
| Number Of Services | 1909 |
| Number Of Medicare Beneficiaries | 431 |
| Total Submitted Charge Amount | 385900 |
| Total Medicare Allowed Amount | 212088.83 |
| Total Medicare Payment Amount | 155084.29 |
| Total Medicare Standardized Payment Amount | 152162.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 3 |
| Number Of Medical Services | 1909 |
| Number Of Medicare Beneficiaries With Medical Services | 431 |
| Total Medical Submitted Charge Amount | 385900 |
| Total Medical Medicare Allowed Amount | 212088.83 |
| Total Medical Medicare Payment Amount | 155084.29 |
| Total Medical Medicare Standardized Payment Amount | 152162.07 |
| Average Age Of Beneficiaries | 51 |
| Number Of Beneficiaries Age Less65 | 355 |
| Number Of Beneficiaries Age 65 to 74 | 55 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 258 |
| Number Of Male Beneficiaries | 173 |
| Number Of Non Hispanic White Beneficiaries | 359 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 79 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 352 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 3 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 64 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 32 |
| Percent Of With Ischemic Heart Disease | 12 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 19 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 21 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1643 |