| National Provider Identifier [NPI]: | 1912904376 |
| Last Name Of The Provider | MOADAB |
| First Name Of The Provider | ANOOSH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6115 N 1ST ST STE 101 |
| Street Address 2 Of The Provider | |
| City Of The Provider | FRESNO |
| Zip Code Of The Provider | 937105450 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 2574 |
| Number Of Medicare Beneficiaries | 527 |
| Total Submitted Charge Amount | 179190 |
| Total Medicare Allowed Amount | 136227.75 |
| Total Medicare Payment Amount | 100206.27 |
| Total Medicare Standardized Payment Amount | 95990.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 125 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 625 |
| Total Drug Medicare AllowedAmount | 242.25 |
| Total Drug Medicare PaymentAmount | 185.52 |
| Total Drug Medicare Standardized Payment Amount | 185.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 2449 |
| Number Of Medicare Beneficiaries With Medical Services | 527 |
| Total Medical Submitted Charge Amount | 178565 |
| Total Medical Medicare Allowed Amount | 135985.5 |
| Total Medical Medicare Payment Amount | 100020.75 |
| Total Medical Medicare Standardized Payment Amount | 95804.99 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 164 |
| Number Of Beneficiaries Age 75 to 84 | 177 |
| Number Of Beneficiaries Age Greater 84 | 145 |
| Number Of Female Beneficiaries | 312 |
| Number Of Male Beneficiaries | 215 |
| Number Of Non Hispanic White Beneficiaries | 381 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 87 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 372 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 155 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5655 |