| National Provider Identifier [NPI]: | 1275616005 |
| Last Name Of The Provider | KAZEM |
| First Name Of The Provider | IMRAN |
| 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 | 19829 N 27TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850274001 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 215 |
| Number Of Services | 4504 |
| Number Of Medicare Beneficiaries | 3045 |
| Total Submitted Charge Amount | 576152.19 |
| Total Medicare Allowed Amount | 145329.79 |
| Total Medicare Payment Amount | 113838.02 |
| Total Medicare Standardized Payment Amount | 115587.82 |
| 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 | 215 |
| Number Of Medical Services | 4504 |
| Number Of Medicare Beneficiaries With Medical Services | 3045 |
| Total Medical Submitted Charge Amount | 576152.19 |
| Total Medical Medicare Allowed Amount | 145329.79 |
| Total Medical Medicare Payment Amount | 113838.02 |
| Total Medical Medicare Standardized Payment Amount | 115587.82 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 403 |
| Number Of Beneficiaries Age 65 to 74 | 1342 |
| Number Of Beneficiaries Age 75 to 84 | 947 |
| Number Of Beneficiaries Age Greater 84 | 353 |
| Number Of Female Beneficiaries | 1827 |
| Number Of Male Beneficiaries | 1218 |
| Number Of Non Hispanic White Beneficiaries | 2389 |
| Number Of Black or African American Beneficiaries | 96 |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | 388 |
| Number Of American Indian Alaska Native Beneficiaries | 120 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2373 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 672 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4922 |