| National Provider Identifier [NPI]: | 1114258944 |
| Last Name Of The Provider | DERDERYAN |
| First Name Of The Provider | EDMOND |
| 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 | 5250 W CENTURY BLVD |
| Street Address 2 Of The Provider | SUITE 333 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900455972 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 8342 |
| Number Of Medicare Beneficiaries | 1767 |
| Total Submitted Charge Amount | 2700513 |
| Total Medicare Allowed Amount | 933623.42 |
| Total Medicare Payment Amount | 729816.84 |
| Total Medicare Standardized Payment Amount | 687932.04 |
| 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 | 45 |
| Number Of Medical Services | 8342 |
| Number Of Medicare Beneficiaries With Medical Services | 1767 |
| Total Medical Submitted Charge Amount | 2700513 |
| Total Medical Medicare Allowed Amount | 933623.42 |
| Total Medical Medicare Payment Amount | 729816.84 |
| Total Medical Medicare Standardized Payment Amount | 687932.04 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 394 |
| Number Of Beneficiaries Age 65 to 74 | 478 |
| Number Of Beneficiaries Age 75 to 84 | 435 |
| Number Of Beneficiaries Age Greater 84 | 460 |
| Number Of Female Beneficiaries | 1007 |
| Number Of Male Beneficiaries | 760 |
| Number Of Non Hispanic White Beneficiaries | 1237 |
| Number Of Black or African American Beneficiaries | 148 |
| Number Of AsianPacific Islander Beneficiaries | 68 |
| Number Of Hispanic Beneficiaries | 265 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 608 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1159 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 51 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 63 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 47 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.704 |