| National Provider Identifier [NPI]: | 1659544203 |
| Last Name Of The Provider | MAHDESSIAN |
| First Name Of The Provider | HOVSEP |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 327 E PALMDALE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PALMDALE |
| Zip Code Of The Provider | 935507139 |
| 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 | 118 |
| Number Of Services | 3493 |
| Number Of Medicare Beneficiaries | 342 |
| Total Submitted Charge Amount | 255216.82 |
| Total Medicare Allowed Amount | 214520.93 |
| Total Medicare Payment Amount | 162271.55 |
| Total Medicare Standardized Payment Amount | 143736.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 26 |
| Number Of Drug Services | 366 |
| Number Of Medicare Beneficiaries With Drug Services | 106 |
| Total Drug Submitted ChargeAmount | 3839.78 |
| Total Drug Medicare AllowedAmount | 594.46 |
| Total Drug Medicare PaymentAmount | 468.18 |
| Total Drug Medicare Standardized Payment Amount | 468.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 3127 |
| Number Of Medicare Beneficiaries With Medical Services | 342 |
| Total Medical Submitted Charge Amount | 251377.04 |
| Total Medical Medicare Allowed Amount | 213926.47 |
| Total Medical Medicare Payment Amount | 161803.37 |
| Total Medical Medicare Standardized Payment Amount | 143268.21 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 125 |
| Number Of Beneficiaries Age 75 to 84 | 118 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 217 |
| Number Of Male Beneficiaries | 125 |
| Number Of Non Hispanic White Beneficiaries | 237 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 164 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 178 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 63 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5339 |