| National Provider Identifier [NPI]: | 1578530291 |
| Last Name Of The Provider | GEVORKIAN |
| First Name Of The Provider | ARTIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 17095 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HESPERIA |
| Zip Code Of The Provider | 923456004 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 120 |
| Number Of Services | 3791 |
| Number Of Medicare Beneficiaries | 648 |
| Total Submitted Charge Amount | 357804.15 |
| Total Medicare Allowed Amount | 120733.04 |
| Total Medicare Payment Amount | 86387.74 |
| Total Medicare Standardized Payment Amount | 88549.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 23 |
| Number Of Drug Services | 2456 |
| Number Of Medicare Beneficiaries With Drug Services | 268 |
| Total Drug Submitted ChargeAmount | 128017.44 |
| Total Drug Medicare AllowedAmount | 59524.11 |
| Total Drug Medicare PaymentAmount | 41771.59 |
| Total Drug Medicare Standardized Payment Amount | 41771.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 97 |
| Number Of Medical Services | 1335 |
| Number Of Medicare Beneficiaries With Medical Services | 647 |
| Total Medical Submitted Charge Amount | 229786.71 |
| Total Medical Medicare Allowed Amount | 61208.93 |
| Total Medical Medicare Payment Amount | 44616.15 |
| Total Medical Medicare Standardized Payment Amount | 46777.6 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 245 |
| Number Of Beneficiaries Age 65 to 74 | 244 |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | 55 |
| Number Of Female Beneficiaries | 413 |
| Number Of Male Beneficiaries | 235 |
| Number Of Non Hispanic White Beneficiaries | 619 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 369 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 279 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.1915 |