| National Provider Identifier [NPI]: | 1972870095 |
| Last Name Of The Provider | CHHIM |
| First Name Of The Provider | DARIYA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2900 N SEPULVEDA BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MANHATTAN BEACH |
| Zip Code Of The Provider | 902662730 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 484 |
| Number Of Medicare Beneficiaries | 254 |
| Total Submitted Charge Amount | 16924.98 |
| Total Medicare Allowed Amount | 16301.07 |
| Total Medicare Payment Amount | 14572.4 |
| Total Medicare Standardized Payment Amount | 15825.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 205 |
| Number Of Medicare Beneficiaries With Drug Services | 197 |
| Total Drug Submitted ChargeAmount | 6524.98 |
| Total Drug Medicare AllowedAmount | 6347.14 |
| Total Drug Medicare PaymentAmount | 6189.2 |
| Total Drug Medicare Standardized Payment Amount | 6189.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 279 |
| Number Of Medicare Beneficiaries With Medical Services | 253 |
| Total Medical Submitted Charge Amount | 10400 |
| Total Medical Medicare Allowed Amount | 9953.93 |
| Total Medical Medicare Payment Amount | 8383.2 |
| Total Medical Medicare Standardized Payment Amount | 9636.42 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 140 |
| Number Of Beneficiaries Age 75 to 84 | 78 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 164 |
| Number Of Male Beneficiaries | 90 |
| Number Of Non Hispanic White Beneficiaries | 224 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8241 |