| National Provider Identifier [NPI]: | 1104923572 |
| Last Name Of The Provider | SOLEIMANPOUR |
| First Name Of The Provider | KAVEH |
| 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 | 3949 LOS FELIZ BLVD. |
| Street Address 2 Of The Provider | APT. 611 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900272324 |
| 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 | 195 |
| Number Of Services | 9426 |
| Number Of Medicare Beneficiaries | 4673 |
| Total Submitted Charge Amount | 924667 |
| Total Medicare Allowed Amount | 295081.54 |
| Total Medicare Payment Amount | 220840.42 |
| Total Medicare Standardized Payment Amount | 209747.36 |
| 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 | 195 |
| Number Of Medical Services | 9426 |
| Number Of Medicare Beneficiaries With Medical Services | 4673 |
| Total Medical Submitted Charge Amount | 924667 |
| Total Medical Medicare Allowed Amount | 295081.54 |
| Total Medical Medicare Payment Amount | 220840.42 |
| Total Medical Medicare Standardized Payment Amount | 209747.36 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 592 |
| Number Of Beneficiaries Age 65 to 74 | 1507 |
| Number Of Beneficiaries Age 75 to 84 | 1567 |
| Number Of Beneficiaries Age Greater 84 | 1007 |
| Number Of Female Beneficiaries | 2740 |
| Number Of Male Beneficiaries | 1933 |
| Number Of Non Hispanic White Beneficiaries | 3100 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 461 |
| Number Of Hispanic Beneficiaries | 777 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 237 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1337 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 3336 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0554 |