| National Provider Identifier [NPI]: | 1912010844 |
| Last Name Of The Provider | SHAHIN |
| First Name Of The Provider | SAMIR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8930 S SEPULVEDA BLVD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900453606 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 1719 |
| Number Of Medicare Beneficiaries | 35 |
| Total Submitted Charge Amount | 57668 |
| Total Medicare Allowed Amount | 52158.2 |
| Total Medicare Payment Amount | 40398.72 |
| Total Medicare Standardized Payment Amount | 37790.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1577 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 44020 |
| Total Drug Medicare AllowedAmount | 42128.28 |
| Total Drug Medicare PaymentAmount | 33119.19 |
| Total Drug Medicare Standardized Payment Amount | 33119.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 142 |
| Number Of Medicare Beneficiaries With Medical Services | 35 |
| Total Medical Submitted Charge Amount | 13648 |
| Total Medical Medicare Allowed Amount | 10029.92 |
| Total Medical Medicare Payment Amount | 7279.53 |
| Total Medical Medicare Standardized Payment Amount | 4671.45 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 18 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 13 |
| Number Of Male Beneficiaries | 22 |
| Number Of Non Hispanic White Beneficiaries | 23 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| 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 | 0 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.721 |