| National Provider Identifier [NPI]: | 1235123142 |
| Last Name Of The Provider | MEHRANY |
| First Name Of The Provider | KHOSROW |
| 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 | 1130 COFFEE RD |
| Street Address 2 Of The Provider | SUITE 5B |
| City Of The Provider | MODESTO |
| Zip Code Of The Provider | 953554228 |
| 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 | 63 |
| Number Of Services | 8524 |
| Number Of Medicare Beneficiaries | 914 |
| Total Submitted Charge Amount | 4925143.6 |
| Total Medicare Allowed Amount | 1704557.41 |
| Total Medicare Payment Amount | 1316366.91 |
| Total Medicare Standardized Payment Amount | 1075175.19 |
| 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 | 63 |
| Number Of Medical Services | 8524 |
| Number Of Medicare Beneficiaries With Medical Services | 914 |
| Total Medical Submitted Charge Amount | 4925143.6 |
| Total Medical Medicare Allowed Amount | 1704557.41 |
| Total Medical Medicare Payment Amount | 1316366.91 |
| Total Medical Medicare Standardized Payment Amount | 1075175.19 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 317 |
| Number Of Beneficiaries Age 75 to 84 | 343 |
| Number Of Beneficiaries Age Greater 84 | 224 |
| Number Of Female Beneficiaries | 391 |
| Number Of Male Beneficiaries | 523 |
| Number Of Non Hispanic White Beneficiaries | 862 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 852 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 62 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1507 |