| National Provider Identifier [NPI]: | 1720010234 |
| Last Name Of The Provider | MOGHADDAM |
| First Name Of The Provider | MOHSEN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19100 VENTURA BLVD STE 16 |
| Street Address 2 Of The Provider | |
| City Of The Provider | TARZANA |
| Zip Code Of The Provider | 913563234 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Otolaryngology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 119 |
| Number Of Services | 22851 |
| Number Of Medicare Beneficiaries | 1311 |
| Total Submitted Charge Amount | 2385487.62 |
| Total Medicare Allowed Amount | 1354141.44 |
| Total Medicare Payment Amount | 1013724.09 |
| Total Medicare Standardized Payment Amount | 929741.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 9752 |
| Number Of Medicare Beneficiaries With Drug Services | 408 |
| Total Drug Submitted ChargeAmount | 330514.04 |
| Total Drug Medicare AllowedAmount | 112141.66 |
| Total Drug Medicare PaymentAmount | 87785.77 |
| Total Drug Medicare Standardized Payment Amount | 87785.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 105 |
| Number Of Medical Services | 13099 |
| Number Of Medicare Beneficiaries With Medical Services | 1311 |
| Total Medical Submitted Charge Amount | 2054973.58 |
| Total Medical Medicare Allowed Amount | 1241999.78 |
| Total Medical Medicare Payment Amount | 925938.32 |
| Total Medical Medicare Standardized Payment Amount | 841956.06 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 118 |
| Number Of Beneficiaries Age 65 to 74 | 517 |
| Number Of Beneficiaries Age 75 to 84 | 457 |
| Number Of Beneficiaries Age Greater 84 | 219 |
| Number Of Female Beneficiaries | 702 |
| Number Of Male Beneficiaries | 609 |
| Number Of Non Hispanic White Beneficiaries | 803 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 330 |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 141 |
| Number Of Beneficiaries With Medicare Only Entitlement | 193 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1118 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 22 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2655 |