| National Provider Identifier [NPI]: | 1265489504 |
| Last Name Of The Provider | AHMADZADEH |
| First Name Of The Provider | SHAHRAM |
| 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 | 2602 FRANKLIN RD SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROANOKE |
| Zip Code Of The Provider | 240141010 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 32490 |
| Number Of Medicare Beneficiaries | 1061 |
| Total Submitted Charge Amount | 6828709 |
| Total Medicare Allowed Amount | 1389401.64 |
| Total Medicare Payment Amount | 1075734.98 |
| Total Medicare Standardized Payment Amount | 1110989.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 26773 |
| Number Of Medicare Beneficiaries With Drug Services | 321 |
| Total Drug Submitted ChargeAmount | 116346 |
| Total Drug Medicare AllowedAmount | 13407.48 |
| Total Drug Medicare PaymentAmount | 10337 |
| Total Drug Medicare Standardized Payment Amount | 10337 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 5717 |
| Number Of Medicare Beneficiaries With Medical Services | 1061 |
| Total Medical Submitted Charge Amount | 6712363 |
| Total Medical Medicare Allowed Amount | 1375994.16 |
| Total Medical Medicare Payment Amount | 1065397.98 |
| Total Medical Medicare Standardized Payment Amount | 1100652.42 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 336 |
| Number Of Beneficiaries Age 65 to 74 | 338 |
| Number Of Beneficiaries Age 75 to 84 | 285 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 494 |
| Number Of Male Beneficiaries | 567 |
| Number Of Non Hispanic White Beneficiaries | 757 |
| Number Of Black or African American Beneficiaries | 283 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 670 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 391 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 64 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 69 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 5.5014 |