| National Provider Identifier [NPI]: | 1659358950 |
| Last Name Of The Provider | SAGHAFI |
| First Name Of The Provider | KOUROSH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6681 RIDGE ROAD |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | PARMA |
| Zip Code Of The Provider | 441295713 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 3916 |
| Number Of Medicare Beneficiaries | 572 |
| Total Submitted Charge Amount | 371071.85 |
| Total Medicare Allowed Amount | 326429.58 |
| Total Medicare Payment Amount | 252024.84 |
| Total Medicare Standardized Payment Amount | 262153.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 679 |
| Total Drug Medicare AllowedAmount | 303.24 |
| Total Drug Medicare PaymentAmount | 292.84 |
| Total Drug Medicare Standardized Payment Amount | 292.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 3890 |
| Number Of Medicare Beneficiaries With Medical Services | 572 |
| Total Medical Submitted Charge Amount | 370392.85 |
| Total Medical Medicare Allowed Amount | 326126.34 |
| Total Medical Medicare Payment Amount | 251732 |
| Total Medical Medicare Standardized Payment Amount | 261860.91 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 97 |
| Number Of Beneficiaries Age 65 to 74 | 159 |
| Number Of Beneficiaries Age 75 to 84 | 146 |
| Number Of Beneficiaries Age Greater 84 | 170 |
| Number Of Female Beneficiaries | 351 |
| Number Of Male Beneficiaries | 221 |
| Number Of Non Hispanic White Beneficiaries | 484 |
| Number Of Black or African American Beneficiaries | 70 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 387 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 185 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 33 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.3993 |