| National Provider Identifier [NPI]: | 1477660090 |
| Last Name Of The Provider | HESHMATI |
| First Name Of The Provider | HEIDAR |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2575 N COURTENAY PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | MERRITT ISLAND |
| Zip Code Of The Provider | 32953 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 577 |
| Number Of Medicare Beneficiaries | 270 |
| Total Submitted Charge Amount | 21238.56 |
| Total Medicare Allowed Amount | 14883.26 |
| Total Medicare Payment Amount | 13581.89 |
| Total Medicare Standardized Payment Amount | 13887.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 281 |
| Number Of Medicare Beneficiaries With Drug Services | 263 |
| Total Drug Submitted ChargeAmount | 14051.4 |
| Total Drug Medicare AllowedAmount | 7807.86 |
| Total Drug Medicare PaymentAmount | 6828.73 |
| Total Drug Medicare Standardized Payment Amount | 6828.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 5 |
| Number Of Medical Services | 296 |
| Number Of Medicare Beneficiaries With Medical Services | 270 |
| Total Medical Submitted Charge Amount | 7187.16 |
| Total Medical Medicare Allowed Amount | 7075.4 |
| Total Medical Medicare Payment Amount | 6753.16 |
| Total Medical Medicare Standardized Payment Amount | 7058.8 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | 91 |
| Number Of Beneficiaries Age Greater 84 | 65 |
| Number Of Female Beneficiaries | 159 |
| Number Of Male Beneficiaries | 111 |
| 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 | 216 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0117 |