| National Provider Identifier [NPI]: | 1114106093 |
| Last Name Of The Provider | SHIRIN |
| First Name Of The Provider | SOPHIE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 16260 VENURA BLVE STE 300 |
| Street Address 2 Of The Provider | |
| City Of The Provider | ENCINO |
| Zip Code Of The Provider | 91436 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 6641 |
| Number Of Medicare Beneficiaries | 1135 |
| Total Submitted Charge Amount | 753117.68 |
| Total Medicare Allowed Amount | 473595.74 |
| Total Medicare Payment Amount | 369086.86 |
| Total Medicare Standardized Payment Amount | 333217.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 6641 |
| Number Of Medicare Beneficiaries With Medical Services | 1135 |
| Total Medical Submitted Charge Amount | 753117.68 |
| Total Medical Medicare Allowed Amount | 473595.74 |
| Total Medical Medicare Payment Amount | 369086.86 |
| Total Medical Medicare Standardized Payment Amount | 333217.62 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 441 |
| Number Of Beneficiaries Age 75 to 84 | 473 |
| Number Of Beneficiaries Age Greater 84 | 158 |
| Number Of Female Beneficiaries | 707 |
| Number Of Male Beneficiaries | 428 |
| Number Of Non Hispanic White Beneficiaries | 1014 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 67 |
| Number Of Beneficiaries With Medicare Only Entitlement | 412 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 723 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 67 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.4138 |