| National Provider Identifier [NPI]: | 1700893864 |
| Last Name Of The Provider | JAZAYERI |
| First Name Of The Provider | SADRA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4045 E BELL RD |
| Street Address 2 Of The Provider | 147 |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 85032 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 8295 |
| Number Of Medicare Beneficiaries | 1494 |
| Total Submitted Charge Amount | 1058575.89 |
| Total Medicare Allowed Amount | 770393 |
| Total Medicare Payment Amount | 575970.63 |
| Total Medicare Standardized Payment Amount | 573279.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 579 |
| Number Of Medicare Beneficiaries With Drug Services | 215 |
| Total Drug Submitted ChargeAmount | 133950.02 |
| Total Drug Medicare AllowedAmount | 120144.53 |
| Total Drug Medicare PaymentAmount | 94032.17 |
| Total Drug Medicare Standardized Payment Amount | 94032.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 7716 |
| Number Of Medicare Beneficiaries With Medical Services | 1494 |
| Total Medical Submitted Charge Amount | 924625.87 |
| Total Medical Medicare Allowed Amount | 650248.47 |
| Total Medical Medicare Payment Amount | 481938.46 |
| Total Medical Medicare Standardized Payment Amount | 479247.03 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 68 |
| Number Of Beneficiaries Age 65 to 74 | 754 |
| Number Of Beneficiaries Age 75 to 84 | 509 |
| Number Of Beneficiaries Age Greater 84 | 163 |
| Number Of Female Beneficiaries | 700 |
| Number Of Male Beneficiaries | 794 |
| Number Of Non Hispanic White Beneficiaries | 1424 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1422 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 72 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9948 |