| National Provider Identifier [NPI]: | 1043445554 |
| Last Name Of The Provider | ABDOLLAHI |
| First Name Of The Provider | MAHSA |
| 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 | 26532 MEADOW CREST DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAGUNA HILLS |
| Zip Code Of The Provider | 92653 |
| 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 | 72 |
| Number Of Services | 3174 |
| Number Of Medicare Beneficiaries | 484 |
| Total Submitted Charge Amount | 395377.95 |
| Total Medicare Allowed Amount | 200381.52 |
| Total Medicare Payment Amount | 155488.98 |
| Total Medicare Standardized Payment Amount | 129174.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 23 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 1775 |
| Total Drug Medicare AllowedAmount | 1016.62 |
| Total Drug Medicare PaymentAmount | 797.03 |
| Total Drug Medicare Standardized Payment Amount | 797.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 3151 |
| Number Of Medicare Beneficiaries With Medical Services | 484 |
| Total Medical Submitted Charge Amount | 393602.95 |
| Total Medical Medicare Allowed Amount | 199364.9 |
| Total Medical Medicare Payment Amount | 154691.95 |
| Total Medical Medicare Standardized Payment Amount | 128377.73 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 209 |
| Number Of Beneficiaries Age 75 to 84 | 146 |
| Number Of Beneficiaries Age Greater 84 | 111 |
| Number Of Female Beneficiaries | 267 |
| Number Of Male Beneficiaries | 217 |
| Number Of Non Hispanic White Beneficiaries | 447 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 466 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0315 |