| National Provider Identifier [NPI]: | 1912165010 |
| Last Name Of The Provider | KHOJABEKYAN |
| First Name Of The Provider | MARINE |
| 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 | 1600 E CITRUS AVE STE A |
| Street Address 2 Of The Provider | |
| City Of The Provider | REDLANDS |
| Zip Code Of The Provider | 923744802 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 267 |
| Number Of Medicare Beneficiaries | 60 |
| Total Submitted Charge Amount | 19559.98 |
| Total Medicare Allowed Amount | 19353.92 |
| Total Medicare Payment Amount | 14190.35 |
| Total Medicare Standardized Payment Amount | 13659.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 30 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 381.45 |
| Total Drug Medicare AllowedAmount | 380.33 |
| Total Drug Medicare PaymentAmount | 359.52 |
| Total Drug Medicare Standardized Payment Amount | 359.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 237 |
| Number Of Medicare Beneficiaries With Medical Services | 60 |
| Total Medical Submitted Charge Amount | 19178.53 |
| Total Medical Medicare Allowed Amount | 18973.59 |
| Total Medical Medicare Payment Amount | 13830.83 |
| Total Medical Medicare Standardized Payment Amount | 13299.53 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 24 |
| Number Of Beneficiaries Age 75 to 84 | 21 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 46 |
| Number Of Male Beneficiaries | 14 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1966 |