| National Provider Identifier [NPI]: | 1013942713 |
| Last Name Of The Provider | DARDASHTI |
| First Name Of The Provider | SIAMAK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1516 COTNER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900253303 |
| 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 | 116 |
| Number Of Services | 5200 |
| Number Of Medicare Beneficiaries | 2133 |
| Total Submitted Charge Amount | 2432980.01 |
| Total Medicare Allowed Amount | 479748.1 |
| Total Medicare Payment Amount | 364296.29 |
| Total Medicare Standardized Payment Amount | 336070.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 2243 |
| Number Of Medicare Beneficiaries With Drug Services | 125 |
| Total Drug Submitted ChargeAmount | 18029.14 |
| Total Drug Medicare AllowedAmount | 4397.13 |
| Total Drug Medicare PaymentAmount | 3180.13 |
| Total Drug Medicare Standardized Payment Amount | 3180.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 110 |
| Number Of Medical Services | 2957 |
| Number Of Medicare Beneficiaries With Medical Services | 2132 |
| Total Medical Submitted Charge Amount | 2414950.87 |
| Total Medical Medicare Allowed Amount | 475350.97 |
| Total Medical Medicare Payment Amount | 361116.16 |
| Total Medical Medicare Standardized Payment Amount | 332890.83 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 269 |
| Number Of Beneficiaries Age 65 to 74 | 966 |
| Number Of Beneficiaries Age 75 to 84 | 663 |
| Number Of Beneficiaries Age Greater 84 | 235 |
| Number Of Female Beneficiaries | 1190 |
| Number Of Male Beneficiaries | 943 |
| Number Of Non Hispanic White Beneficiaries | 1542 |
| Number Of Black or African American Beneficiaries | 173 |
| Number Of AsianPacific Islander Beneficiaries | 150 |
| Number Of Hispanic Beneficiaries | 186 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1311 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 822 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2489 |