| National Provider Identifier [NPI]: | 1639386626 |
| Last Name Of The Provider | RAMIN |
| First Name Of The Provider | SOROUSH |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12922 VICTORY BLVD |
| Street Address 2 Of The Provider | ASSUTA FAMILY MEDICAL GROUP APMC |
| City Of The Provider | NORTH HOLLYWOOD |
| Zip Code Of The Provider | 916062924 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 146 |
| Number Of Services | 7436 |
| Number Of Medicare Beneficiaries | 707 |
| Total Submitted Charge Amount | 3141305 |
| Total Medicare Allowed Amount | 652535.74 |
| Total Medicare Payment Amount | 503657.06 |
| Total Medicare Standardized Payment Amount | 463333.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 746 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 111630 |
| Total Drug Medicare AllowedAmount | 37641.49 |
| Total Drug Medicare PaymentAmount | 29482.08 |
| Total Drug Medicare Standardized Payment Amount | 29482.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 137 |
| Number Of Medical Services | 6690 |
| Number Of Medicare Beneficiaries With Medical Services | 707 |
| Total Medical Submitted Charge Amount | 3029675 |
| Total Medical Medicare Allowed Amount | 614894.25 |
| Total Medical Medicare Payment Amount | 474174.98 |
| Total Medical Medicare Standardized Payment Amount | 433851.88 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 333 |
| Number Of Beneficiaries Age 75 to 84 | 259 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 125 |
| Number Of Male Beneficiaries | 582 |
| Number Of Non Hispanic White Beneficiaries | 463 |
| Number Of Black or African American Beneficiaries | 38 |
| Number Of AsianPacific Islander Beneficiaries | 107 |
| Number Of Hispanic Beneficiaries | 55 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 400 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 307 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 31 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3915 |