| National Provider Identifier [NPI]: | 1508024126 |
| Last Name Of The Provider | DEHDARI |
| First Name Of The Provider | REZA |
| 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 | 2615 SAINT SIMONS |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUSTIN |
| Zip Code Of The Provider | 927821229 |
| 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 | 171 |
| Number Of Services | 8910 |
| Number Of Medicare Beneficiaries | 3181 |
| Total Submitted Charge Amount | 189663.55 |
| Total Medicare Allowed Amount | 178586.73 |
| Total Medicare Payment Amount | 134667.05 |
| Total Medicare Standardized Payment Amount | 131061.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 171 |
| Number Of Medical Services | 8910 |
| Number Of Medicare Beneficiaries With Medical Services | 3181 |
| Total Medical Submitted Charge Amount | 189663.55 |
| Total Medical Medicare Allowed Amount | 178586.73 |
| Total Medical Medicare Payment Amount | 134667.05 |
| Total Medical Medicare Standardized Payment Amount | 131061.39 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 656 |
| Number Of Beneficiaries Age 65 to 74 | 881 |
| Number Of Beneficiaries Age 75 to 84 | 888 |
| Number Of Beneficiaries Age Greater 84 | 756 |
| Number Of Female Beneficiaries | 1710 |
| Number Of Male Beneficiaries | 1471 |
| Number Of Non Hispanic White Beneficiaries | 1401 |
| Number Of Black or African American Beneficiaries | 351 |
| Number Of AsianPacific Islander Beneficiaries | 484 |
| Number Of Hispanic Beneficiaries | 877 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 885 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2296 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 50 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 62 |
| Percent Of With Chronic Kidney Disease | 66 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 56 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 64 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 30 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 3.4634 |