| National Provider Identifier [NPI]: | 1619060456 |
| Last Name Of The Provider | BROUKHIM |
| First Name Of The Provider | KAMRAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D, |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1762 WESTWOOD BLVD |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900245632 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 428 |
| Number Of Medicare Beneficiaries | 155 |
| Total Submitted Charge Amount | 39827 |
| Total Medicare Allowed Amount | 22128 |
| Total Medicare Payment Amount | 15354.52 |
| Total Medicare Standardized Payment Amount | 15383.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1139 |
| Total Drug Medicare AllowedAmount | 684.47 |
| Total Drug Medicare PaymentAmount | 669.63 |
| Total Drug Medicare Standardized Payment Amount | 669.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 406 |
| Number Of Medicare Beneficiaries With Medical Services | 155 |
| Total Medical Submitted Charge Amount | 38688 |
| Total Medical Medicare Allowed Amount | 21443.53 |
| Total Medical Medicare Payment Amount | 14684.89 |
| Total Medical Medicare Standardized Payment Amount | 14713.48 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 60 |
| Number Of Beneficiaries Age 75 to 84 | 56 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 76 |
| Number Of Male Beneficiaries | 79 |
| Number Of Non Hispanic White Beneficiaries | 93 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 30 |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 39 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 116 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1047 |