| National Provider Identifier [NPI]: | 1770548893 |
| Last Name Of The Provider | MOGHADAM |
| First Name Of The Provider | FARANAK |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3357B CORRIDOR MARKETPLACE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAUREL |
| Zip Code Of The Provider | 207242381 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 1415 |
| Number Of Medicare Beneficiaries | 506 |
| Total Submitted Charge Amount | 119575 |
| Total Medicare Allowed Amount | 52260.9 |
| Total Medicare Payment Amount | 37293.54 |
| Total Medicare Standardized Payment Amount | 36786.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 169 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 4372 |
| Total Drug Medicare AllowedAmount | 2063.35 |
| Total Drug Medicare PaymentAmount | 1989.17 |
| Total Drug Medicare Standardized Payment Amount | 1989.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 1246 |
| Number Of Medicare Beneficiaries With Medical Services | 503 |
| Total Medical Submitted Charge Amount | 115203 |
| Total Medical Medicare Allowed Amount | 50197.55 |
| Total Medical Medicare Payment Amount | 35304.37 |
| Total Medical Medicare Standardized Payment Amount | 34797.37 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 263 |
| Number Of Beneficiaries Age 75 to 84 | 135 |
| Number Of Beneficiaries Age Greater 84 | 42 |
| Number Of Female Beneficiaries | 329 |
| Number Of Male Beneficiaries | 177 |
| Number Of Non Hispanic White Beneficiaries | 302 |
| Number Of Black or African American Beneficiaries | 176 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 465 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.936 |