| National Provider Identifier [NPI]: | 1255370334 |
| Last Name Of The Provider | BROUMANDI |
| First Name Of The Provider | DAVID |
| 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 | 10401 WILSHIRE BLVD |
| Street Address 2 Of The Provider | 904 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900244609 |
| 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 | 223 |
| Number Of Services | 6098 |
| Number Of Medicare Beneficiaries | 2802 |
| Total Submitted Charge Amount | 1003610 |
| Total Medicare Allowed Amount | 229189.31 |
| Total Medicare Payment Amount | 169606.19 |
| Total Medicare Standardized Payment Amount | 160776.09 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 488 |
| Number Of Beneficiaries Age 65 to 74 | 867 |
| Number Of Beneficiaries Age 75 to 84 | 863 |
| Number Of Beneficiaries Age Greater 84 | 584 |
| Number Of Female Beneficiaries | 1664 |
| Number Of Male Beneficiaries | 1138 |
| Number Of Non Hispanic White Beneficiaries | 1254 |
| Number Of Black or African American Beneficiaries | 135 |
| Number Of AsianPacific Islander Beneficiaries | 194 |
| Number Of Hispanic Beneficiaries | 1149 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1138 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1664 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.5777 |