| National Provider Identifier [NPI]: | 1629094826 |
| Last Name Of The Provider | KEYASHIAN |
| First Name Of The Provider | MOHSEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6801 ROGERS AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT SMITH |
| Zip Code Of The Provider | 729034067 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 5852 |
| Number Of Medicare Beneficiaries | 775 |
| Total Submitted Charge Amount | 484854 |
| Total Medicare Allowed Amount | 246798 |
| Total Medicare Payment Amount | 166303.88 |
| Total Medicare Standardized Payment Amount | 185867.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 2610 |
| Number Of Medicare Beneficiaries With Drug Services | 355 |
| Total Drug Submitted ChargeAmount | 81895 |
| Total Drug Medicare AllowedAmount | 29113.79 |
| Total Drug Medicare PaymentAmount | 24978.25 |
| Total Drug Medicare Standardized Payment Amount | 24978.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 3242 |
| Number Of Medicare Beneficiaries With Medical Services | 775 |
| Total Medical Submitted Charge Amount | 402959 |
| Total Medical Medicare Allowed Amount | 217684.21 |
| Total Medical Medicare Payment Amount | 141325.63 |
| Total Medical Medicare Standardized Payment Amount | 160889.43 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 370 |
| Number Of Beneficiaries Age 75 to 84 | 284 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 460 |
| Number Of Male Beneficiaries | 315 |
| Number Of Non Hispanic White Beneficiaries | 724 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| 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 | 721 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8368 |