| National Provider Identifier [NPI]: | 1902917883 |
| Last Name Of The Provider | KOMSHIAN |
| First Name Of The Provider | SHAHE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2585 SAMARITAN DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN JOSE |
| Zip Code Of The Provider | 951244107 |
| 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 | 31 |
| Number Of Services | 1460 |
| Number Of Medicare Beneficiaries | 219 |
| Total Submitted Charge Amount | 294680.16 |
| Total Medicare Allowed Amount | 131051.02 |
| Total Medicare Payment Amount | 93601.71 |
| Total Medicare Standardized Payment Amount | 79388.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 194 |
| Number Of Medicare Beneficiaries With Drug Services | 95 |
| Total Drug Submitted ChargeAmount | 6441.56 |
| Total Drug Medicare AllowedAmount | 2990.93 |
| Total Drug Medicare PaymentAmount | 2882.47 |
| Total Drug Medicare Standardized Payment Amount | 2882.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 1266 |
| Number Of Medicare Beneficiaries With Medical Services | 219 |
| Total Medical Submitted Charge Amount | 288238.6 |
| Total Medical Medicare Allowed Amount | 128060.09 |
| Total Medical Medicare Payment Amount | 90719.24 |
| Total Medical Medicare Standardized Payment Amount | 76506.08 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 87 |
| Number Of Beneficiaries Age 75 to 84 | 74 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 95 |
| Number Of Male Beneficiaries | 124 |
| Number Of Non Hispanic White Beneficiaries | 180 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 187 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.136 |