| National Provider Identifier [NPI]: | 1114184074 |
| Last Name Of The Provider | ESMAILI |
| First Name Of The Provider | ALI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 927 N LANTANA WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | AZUSA |
| Zip Code Of The Provider | 917021571 |
| 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 | 25 |
| Number Of Services | 2970 |
| Number Of Medicare Beneficiaries | 1385 |
| Total Submitted Charge Amount | 518968.23 |
| Total Medicare Allowed Amount | 244323.26 |
| Total Medicare Payment Amount | 222462.36 |
| Total Medicare Standardized Payment Amount | 199965.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 891 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 3810 |
| Total Drug Medicare AllowedAmount | 710.49 |
| Total Drug Medicare PaymentAmount | 532.35 |
| Total Drug Medicare Standardized Payment Amount | 532.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 2079 |
| Number Of Medicare Beneficiaries With Medical Services | 1385 |
| Total Medical Submitted Charge Amount | 515158.23 |
| Total Medical Medicare Allowed Amount | 243612.77 |
| Total Medical Medicare Payment Amount | 221930.01 |
| Total Medical Medicare Standardized Payment Amount | 199433.36 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 142 |
| Number Of Beneficiaries Age 65 to 74 | 790 |
| Number Of Beneficiaries Age 75 to 84 | 369 |
| Number Of Beneficiaries Age Greater 84 | 84 |
| Number Of Female Beneficiaries | 1348 |
| Number Of Male Beneficiaries | 37 |
| Number Of Non Hispanic White Beneficiaries | 921 |
| Number Of Black or African American Beneficiaries | 117 |
| Number Of AsianPacific Islander Beneficiaries | 121 |
| Number Of Hispanic Beneficiaries | 176 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 890 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 495 |
| Percent Of With Atrial Fibrillation | 3 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.9307 |