| National Provider Identifier [NPI]: | 1710189097 |
| Last Name Of The Provider | IRANMANESH |
| First Name Of The Provider | HAMIDREZA |
| 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 | 4301 GARTH RD |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | BAYTOWN |
| Zip Code Of The Provider | 775213153 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 2592 |
| Number Of Medicare Beneficiaries | 545 |
| Total Submitted Charge Amount | 244887.5 |
| Total Medicare Allowed Amount | 120341.8 |
| Total Medicare Payment Amount | 86827.52 |
| Total Medicare Standardized Payment Amount | 87231.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 1150 |
| Number Of Medicare Beneficiaries With Drug Services | 123 |
| Total Drug Submitted ChargeAmount | 5532.5 |
| Total Drug Medicare AllowedAmount | 464.19 |
| Total Drug Medicare PaymentAmount | 345.34 |
| Total Drug Medicare Standardized Payment Amount | 345.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 1442 |
| Number Of Medicare Beneficiaries With Medical Services | 545 |
| Total Medical Submitted Charge Amount | 239355 |
| Total Medical Medicare Allowed Amount | 119877.61 |
| Total Medical Medicare Payment Amount | 86482.18 |
| Total Medical Medicare Standardized Payment Amount | 86886.16 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 102 |
| Number Of Beneficiaries Age 65 to 74 | 254 |
| Number Of Beneficiaries Age 75 to 84 | 119 |
| Number Of Beneficiaries Age Greater 84 | 70 |
| Number Of Female Beneficiaries | 320 |
| Number Of Male Beneficiaries | 225 |
| Number Of Non Hispanic White Beneficiaries | 423 |
| Number Of Black or African American Beneficiaries | 59 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 463 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 82 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8234 |