| National Provider Identifier [NPI]: | 1578581484 |
| Last Name Of The Provider | KAZEMI |
| First Name Of The Provider | SHOELEH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 865 JEFFERSON AVENUE, F150 CHANDLER |
| Street Address 2 Of The Provider | UNIVERISTY OF TENNESSE HEALTH SCIENCE CTR,RADIOLOG DEPT |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 38163 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 121 |
| Number Of Services | 4183 |
| Number Of Medicare Beneficiaries | 2660 |
| Total Submitted Charge Amount | 442086 |
| Total Medicare Allowed Amount | 130852.05 |
| Total Medicare Payment Amount | 102546.11 |
| Total Medicare Standardized Payment Amount | 102126.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 121 |
| Number Of Medical Services | 4183 |
| Number Of Medicare Beneficiaries With Medical Services | 2660 |
| Total Medical Submitted Charge Amount | 442086 |
| Total Medical Medicare Allowed Amount | 130852.05 |
| Total Medical Medicare Payment Amount | 102546.11 |
| Total Medical Medicare Standardized Payment Amount | 102126.94 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 659 |
| Number Of Beneficiaries Age 65 to 74 | 883 |
| Number Of Beneficiaries Age 75 to 84 | 629 |
| Number Of Beneficiaries Age Greater 84 | 489 |
| Number Of Female Beneficiaries | 1758 |
| Number Of Male Beneficiaries | 902 |
| Number Of Non Hispanic White Beneficiaries | 1933 |
| Number Of Black or African American Beneficiaries | 224 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 432 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1499 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1161 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4971 |