| National Provider Identifier [NPI]: | 1063555845 |
| Last Name Of The Provider | TABIB |
| First Name Of The Provider | SIAMAK |
| 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 | 8631 W 3RD ST |
| Street Address 2 Of The Provider | SUITE 1015E |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900485901 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 1231 |
| Number Of Medicare Beneficiaries | 368 |
| Total Submitted Charge Amount | 880700 |
| Total Medicare Allowed Amount | 151509.64 |
| Total Medicare Payment Amount | 117293.13 |
| Total Medicare Standardized Payment Amount | 109808.17 |
| 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 | 29 |
| Number Of Medical Services | 1231 |
| Number Of Medicare Beneficiaries With Medical Services | 368 |
| Total Medical Submitted Charge Amount | 880700 |
| Total Medical Medicare Allowed Amount | 151509.64 |
| Total Medical Medicare Payment Amount | 117293.13 |
| Total Medical Medicare Standardized Payment Amount | 109808.17 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 184 |
| Number Of Beneficiaries Age 75 to 84 | 102 |
| Number Of Beneficiaries Age Greater 84 | 49 |
| Number Of Female Beneficiaries | 195 |
| Number Of Male Beneficiaries | 173 |
| Number Of Non Hispanic White Beneficiaries | 243 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | 44 |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 246 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 122 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4899 |