| National Provider Identifier [NPI]: | 1497735906 |
| Last Name Of The Provider | ABSOOD |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 420 W ROWLAND ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | COVINA |
| Zip Code Of The Provider | 917232943 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pediatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 1111 |
| Number Of Medicare Beneficiaries | 236 |
| Total Submitted Charge Amount | 116825 |
| Total Medicare Allowed Amount | 82652.15 |
| Total Medicare Payment Amount | 61035.52 |
| Total Medicare Standardized Payment Amount | 56258.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 112 |
| Number Of Medicare Beneficiaries With Drug Services | 63 |
| Total Drug Submitted ChargeAmount | 5112 |
| Total Drug Medicare AllowedAmount | 2758.85 |
| Total Drug Medicare PaymentAmount | 2652.46 |
| Total Drug Medicare Standardized Payment Amount | 2652.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 999 |
| Number Of Medicare Beneficiaries With Medical Services | 236 |
| Total Medical Submitted Charge Amount | 111713 |
| Total Medical Medicare Allowed Amount | 79893.3 |
| Total Medical Medicare Payment Amount | 58383.06 |
| Total Medical Medicare Standardized Payment Amount | 53606.2 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 104 |
| Number Of Beneficiaries Age 75 to 84 | 59 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 170 |
| Number Of Male Beneficiaries | 66 |
| Number Of Non Hispanic White Beneficiaries | 169 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 192 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0829 |