| National Provider Identifier [NPI]: | 1013112820 |
| Last Name Of The Provider | MORTEZAIE |
| First Name Of The Provider | ALAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2301 BAHAMAS DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BAKERSFIELD |
| Zip Code Of The Provider | 933090663 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 178 |
| Number Of Services | 22664 |
| Number Of Medicare Beneficiaries | 2469 |
| Total Submitted Charge Amount | 859370 |
| Total Medicare Allowed Amount | 281370.82 |
| Total Medicare Payment Amount | 208434.33 |
| Total Medicare Standardized Payment Amount | 203341.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 18638 |
| Number Of Medicare Beneficiaries With Drug Services | 216 |
| Total Drug Submitted ChargeAmount | 25191 |
| Total Drug Medicare AllowedAmount | 5949.48 |
| Total Drug Medicare PaymentAmount | 4625.78 |
| Total Drug Medicare Standardized Payment Amount | 4625.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 171 |
| Number Of Medical Services | 4026 |
| Number Of Medicare Beneficiaries With Medical Services | 2469 |
| Total Medical Submitted Charge Amount | 834179 |
| Total Medical Medicare Allowed Amount | 275421.34 |
| Total Medical Medicare Payment Amount | 203808.55 |
| Total Medical Medicare Standardized Payment Amount | 198715.39 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 613 |
| Number Of Beneficiaries Age 65 to 74 | 909 |
| Number Of Beneficiaries Age 75 to 84 | 611 |
| Number Of Beneficiaries Age Greater 84 | 336 |
| Number Of Female Beneficiaries | 1429 |
| Number Of Male Beneficiaries | 1040 |
| Number Of Non Hispanic White Beneficiaries | 1531 |
| Number Of Black or African American Beneficiaries | 171 |
| Number Of AsianPacific Islander Beneficiaries | 90 |
| Number Of Hispanic Beneficiaries | 637 |
| Number Of American Indian Alaska Native Beneficiaries | 21 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1282 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1187 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.068 |