| National Provider Identifier [NPI]: | 1699940494 |
| Last Name Of The Provider | DANESHVAR |
| First Name Of The Provider | SAMUEL |
| 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 | 2020 SANTA MONICA BLVD |
| Street Address 2 Of The Provider | SUITE 220 |
| City Of The Provider | SANTA MONICA |
| Zip Code Of The Provider | 904042023 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 3140 |
| Number Of Medicare Beneficiaries | 1313 |
| Total Submitted Charge Amount | 722450.11 |
| Total Medicare Allowed Amount | 212239.77 |
| Total Medicare Payment Amount | 162178.93 |
| Total Medicare Standardized Payment Amount | 154890.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 154 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 38855 |
| Total Drug Medicare AllowedAmount | 8136.53 |
| Total Drug Medicare PaymentAmount | 6379.11 |
| Total Drug Medicare Standardized Payment Amount | 6379.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 2986 |
| Number Of Medicare Beneficiaries With Medical Services | 1313 |
| Total Medical Submitted Charge Amount | 683595.11 |
| Total Medical Medicare Allowed Amount | 204103.24 |
| Total Medical Medicare Payment Amount | 155799.82 |
| Total Medical Medicare Standardized Payment Amount | 148511.69 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 127 |
| Number Of Beneficiaries Age 65 to 74 | 390 |
| Number Of Beneficiaries Age 75 to 84 | 418 |
| Number Of Beneficiaries Age Greater 84 | 378 |
| Number Of Female Beneficiaries | 751 |
| Number Of Male Beneficiaries | 562 |
| Number Of Non Hispanic White Beneficiaries | 904 |
| Number Of Black or African American Beneficiaries | 142 |
| Number Of AsianPacific Islander Beneficiaries | 100 |
| Number Of Hispanic Beneficiaries | 138 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 869 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 444 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.1857 |