| National Provider Identifier [NPI]: | 1689788234 |
| Last Name Of The Provider | MOUSSAVIAN |
| First Name Of The Provider | MEHRAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 754 MEDICAL CENTER CT |
| Street Address 2 Of The Provider | SUITE 204 |
| City Of The Provider | CHULA VISTA |
| Zip Code Of The Provider | 919116654 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 97 |
| Number Of Services | 15964 |
| Number Of Medicare Beneficiaries | 2087 |
| Total Submitted Charge Amount | 4181022.62 |
| Total Medicare Allowed Amount | 2098671.1 |
| Total Medicare Payment Amount | 1591324.17 |
| Total Medicare Standardized Payment Amount | 1514774.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2777 |
| Number Of Medicare Beneficiaries With Drug Services | 603 |
| Total Drug Submitted ChargeAmount | 278735 |
| Total Drug Medicare AllowedAmount | 115055.5 |
| Total Drug Medicare PaymentAmount | 90201.4 |
| Total Drug Medicare Standardized Payment Amount | 90201.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 13187 |
| Number Of Medicare Beneficiaries With Medical Services | 2087 |
| Total Medical Submitted Charge Amount | 3902287.62 |
| Total Medical Medicare Allowed Amount | 1983615.6 |
| Total Medical Medicare Payment Amount | 1501122.77 |
| Total Medical Medicare Standardized Payment Amount | 1424573.48 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 273 |
| Number Of Beneficiaries Age 65 to 74 | 810 |
| Number Of Beneficiaries Age 75 to 84 | 673 |
| Number Of Beneficiaries Age Greater 84 | 331 |
| Number Of Female Beneficiaries | 1159 |
| Number Of Male Beneficiaries | 928 |
| Number Of Non Hispanic White Beneficiaries | 543 |
| Number Of Black or African American Beneficiaries | 105 |
| Number Of AsianPacific Islander Beneficiaries | 239 |
| Number Of Hispanic Beneficiaries | 1109 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 793 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1294 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 54 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8563 |