| National Provider Identifier [NPI]: | 1659537306 |
| Last Name Of The Provider | NOORISTANI |
| First Name Of The Provider | AHMAD |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1428 PHILLIPS LANE |
| Street Address 2 Of The Provider | SUITE B-5 |
| City Of The Provider | SAN LUIS OBISPO |
| Zip Code Of The Provider | 934012537 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 1362 |
| Number Of Medicare Beneficiaries | 517 |
| Total Submitted Charge Amount | 275780 |
| Total Medicare Allowed Amount | 157564.85 |
| Total Medicare Payment Amount | 121776.25 |
| Total Medicare Standardized Payment Amount | 118800.6 |
| 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 | 19 |
| Number Of Medical Services | 1362 |
| Number Of Medicare Beneficiaries With Medical Services | 517 |
| Total Medical Submitted Charge Amount | 275780 |
| Total Medical Medicare Allowed Amount | 157564.85 |
| Total Medical Medicare Payment Amount | 121776.25 |
| Total Medical Medicare Standardized Payment Amount | 118800.6 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 116 |
| Number Of Beneficiaries Age 75 to 84 | 167 |
| Number Of Beneficiaries Age Greater 84 | 169 |
| Number Of Female Beneficiaries | 274 |
| Number Of Male Beneficiaries | 243 |
| Number Of Non Hispanic White Beneficiaries | 472 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 411 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 106 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.066 |