| National Provider Identifier [NPI]: | 1356454557 |
| Last Name Of The Provider | MEHRABI |
| First Name Of The Provider | DONNY |
| 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 | 9735 WILSHIRE BLVD |
| Street Address 2 Of The Provider | SUITE 421 |
| City Of The Provider | BEVERLY HILLS |
| Zip Code Of The Provider | 902122107 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 3302 |
| Number Of Medicare Beneficiaries | 657 |
| Total Submitted Charge Amount | 519358.87 |
| Total Medicare Allowed Amount | 304109.36 |
| Total Medicare Payment Amount | 226837 |
| Total Medicare Standardized Payment Amount | 198742.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 125 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 3796 |
| Total Drug Medicare AllowedAmount | 225.5 |
| Total Drug Medicare PaymentAmount | 159.95 |
| Total Drug Medicare Standardized Payment Amount | 159.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 3177 |
| Number Of Medicare Beneficiaries With Medical Services | 657 |
| Total Medical Submitted Charge Amount | 515562.87 |
| Total Medical Medicare Allowed Amount | 303883.86 |
| Total Medical Medicare Payment Amount | 226677.05 |
| Total Medical Medicare Standardized Payment Amount | 198582.99 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 294 |
| Number Of Beneficiaries Age 75 to 84 | 216 |
| Number Of Beneficiaries Age Greater 84 | 78 |
| Number Of Female Beneficiaries | 338 |
| Number Of Male Beneficiaries | 319 |
| Number Of Non Hispanic White Beneficiaries | 513 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 46 |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 354 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 303 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3597 |