| National Provider Identifier [NPI]: | 1255308904 |
| Last Name Of The Provider | BEHRAVAN |
| First Name Of The Provider | HOOMAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13690 E 14TH ST |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | SAN LEANDRO |
| Zip Code Of The Provider | 945782582 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 2128 |
| Number Of Medicare Beneficiaries | 214 |
| Total Submitted Charge Amount | 485118 |
| Total Medicare Allowed Amount | 231380.09 |
| Total Medicare Payment Amount | 172778.59 |
| Total Medicare Standardized Payment Amount | 142753.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 692 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 6850 |
| Total Drug Medicare AllowedAmount | 2240.44 |
| Total Drug Medicare PaymentAmount | 1756.53 |
| Total Drug Medicare Standardized Payment Amount | 1756.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 1436 |
| Number Of Medicare Beneficiaries With Medical Services | 214 |
| Total Medical Submitted Charge Amount | 478268 |
| Total Medical Medicare Allowed Amount | 229139.65 |
| Total Medical Medicare Payment Amount | 171022.06 |
| Total Medical Medicare Standardized Payment Amount | 140996.77 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 70 |
| Number Of Beneficiaries Age 65 to 74 | 80 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 130 |
| Number Of Male Beneficiaries | 84 |
| Number Of Non Hispanic White Beneficiaries | 134 |
| Number Of Black or African American Beneficiaries | 43 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 147 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 67 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.307 |