| National Provider Identifier [NPI]: | 1104877497 |
| Last Name Of The Provider | SHAHROKNI |
| First Name Of The Provider | SEYED |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 27725 SANTA MARGARITA PARKWAY |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | MISSION VIEJO |
| Zip Code Of The Provider | 926916706 |
| 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 | 166 |
| Number Of Services | 11959 |
| Number Of Medicare Beneficiaries | 1852 |
| Total Submitted Charge Amount | 1593343.5 |
| Total Medicare Allowed Amount | 426836 |
| Total Medicare Payment Amount | 342216.05 |
| Total Medicare Standardized Payment Amount | 295445.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 8300 |
| Number Of Medicare Beneficiaries With Drug Services | 163 |
| Total Drug Submitted ChargeAmount | 16980 |
| Total Drug Medicare AllowedAmount | 5539.29 |
| Total Drug Medicare PaymentAmount | 4342.92 |
| Total Drug Medicare Standardized Payment Amount | 4342.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 163 |
| Number Of Medical Services | 3659 |
| Number Of Medicare Beneficiaries With Medical Services | 1852 |
| Total Medical Submitted Charge Amount | 1576363.5 |
| Total Medical Medicare Allowed Amount | 421296.71 |
| Total Medical Medicare Payment Amount | 337873.13 |
| Total Medical Medicare Standardized Payment Amount | 291102.13 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 178 |
| Number Of Beneficiaries Age 65 to 74 | 815 |
| Number Of Beneficiaries Age 75 to 84 | 546 |
| Number Of Beneficiaries Age Greater 84 | 313 |
| Number Of Female Beneficiaries | 1251 |
| Number Of Male Beneficiaries | 601 |
| Number Of Non Hispanic White Beneficiaries | 1360 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 211 |
| Number Of Hispanic Beneficiaries | 192 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 61 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1286 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 566 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3046 |