| National Provider Identifier [NPI]: | 1114959798 |
| Last Name Of The Provider | GHAHREMANI |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 W ARBOR DR |
| Street Address 2 Of The Provider | MAIL CODE 8756 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921039001 |
| 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 | 36 |
| Number Of Services | 2107 |
| Number Of Medicare Beneficiaries | 1569 |
| Total Submitted Charge Amount | 507708 |
| Total Medicare Allowed Amount | 104245.96 |
| Total Medicare Payment Amount | 74642.06 |
| Total Medicare Standardized Payment Amount | 74174.03 |
| 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 | 36 |
| Number Of Medical Services | 2107 |
| Number Of Medicare Beneficiaries With Medical Services | 1569 |
| Total Medical Submitted Charge Amount | 507708 |
| Total Medical Medicare Allowed Amount | 104245.96 |
| Total Medical Medicare Payment Amount | 74642.06 |
| Total Medical Medicare Standardized Payment Amount | 74174.03 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 347 |
| Number Of Beneficiaries Age 65 to 74 | 644 |
| Number Of Beneficiaries Age 75 to 84 | 399 |
| Number Of Beneficiaries Age Greater 84 | 179 |
| Number Of Female Beneficiaries | 739 |
| Number Of Male Beneficiaries | 830 |
| Number Of Non Hispanic White Beneficiaries | 1007 |
| Number Of Black or African American Beneficiaries | 113 |
| Number Of AsianPacific Islander Beneficiaries | 132 |
| Number Of Hispanic Beneficiaries | 268 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 968 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 601 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.2934 |