| National Provider Identifier [NPI]: | 1508825381 |
| Last Name Of The Provider | SIAL |
| First Name Of The Provider | KHURAM |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1810 FULLERTON AVE |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | CORONA |
| Zip Code Of The Provider | 928813103 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 3919.1 |
| Number Of Medicare Beneficiaries | 484 |
| Total Submitted Charge Amount | 785076 |
| Total Medicare Allowed Amount | 375329.22 |
| Total Medicare Payment Amount | 287253.59 |
| Total Medicare Standardized Payment Amount | 268162.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 333 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 3435 |
| Total Drug Medicare AllowedAmount | 102.1 |
| Total Drug Medicare PaymentAmount | 80.11 |
| Total Drug Medicare Standardized Payment Amount | 80.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 3586.1 |
| Number Of Medicare Beneficiaries With Medical Services | 484 |
| Total Medical Submitted Charge Amount | 781641 |
| Total Medical Medicare Allowed Amount | 375227.12 |
| Total Medical Medicare Payment Amount | 287173.48 |
| Total Medical Medicare Standardized Payment Amount | 268082.54 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 180 |
| Number Of Beneficiaries Age 65 to 74 | 169 |
| Number Of Beneficiaries Age 75 to 84 | 82 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 291 |
| Number Of Male Beneficiaries | 193 |
| Number Of Non Hispanic White Beneficiaries | 373 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 328 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 156 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.433 |