| National Provider Identifier [NPI]: | 1669685111 |
| Last Name Of The Provider | SIMONYANTS |
| First Name Of The Provider | LUSINE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1511 W GLENOAKS BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GLENDALE |
| Zip Code Of The Provider | 912011912 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 1643 |
| Number Of Medicare Beneficiaries | 333 |
| Total Submitted Charge Amount | 461175 |
| Total Medicare Allowed Amount | 160451.22 |
| Total Medicare Payment Amount | 125795.73 |
| Total Medicare Standardized Payment Amount | 105800.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 825 |
| Total Drug Medicare AllowedAmount | 5.9 |
| Total Drug Medicare PaymentAmount | 4.62 |
| Total Drug Medicare Standardized Payment Amount | 4.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 1610 |
| Number Of Medicare Beneficiaries With Medical Services | 333 |
| Total Medical Submitted Charge Amount | 460350 |
| Total Medical Medicare Allowed Amount | 160445.32 |
| Total Medical Medicare Payment Amount | 125791.11 |
| Total Medical Medicare Standardized Payment Amount | 105796.22 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 89 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 94 |
| Number Of Female Beneficiaries | 181 |
| Number Of Male Beneficiaries | 152 |
| Number Of Non Hispanic White Beneficiaries | 239 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 64 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 269 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 41 |
| Percent Of With Asthma | 26 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 67 |
| Percent Of With Chronic Kidney Disease | 58 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 56 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 66 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 3.0176 |