| National Provider Identifier [NPI]: | 1184664997 |
| Last Name Of The Provider | NOURI |
| First Name Of The Provider | KEYVAN |
| 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 | 2125 OAK GROVE RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | WALNUT CREEK |
| Zip Code Of The Provider | 945982536 |
| 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 | 166 |
| Number Of Services | 4703 |
| Number Of Medicare Beneficiaries | 2498 |
| Total Submitted Charge Amount | 700370 |
| Total Medicare Allowed Amount | 146611.34 |
| Total Medicare Payment Amount | 117105.89 |
| Total Medicare Standardized Payment Amount | 109373.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 166 |
| Number Of Medical Services | 4703 |
| Number Of Medicare Beneficiaries With Medical Services | 2498 |
| Total Medical Submitted Charge Amount | 700370 |
| Total Medical Medicare Allowed Amount | 146611.34 |
| Total Medical Medicare Payment Amount | 117105.89 |
| Total Medical Medicare Standardized Payment Amount | 109373.06 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 443 |
| Number Of Beneficiaries Age 65 to 74 | 777 |
| Number Of Beneficiaries Age 75 to 84 | 692 |
| Number Of Beneficiaries Age Greater 84 | 586 |
| Number Of Female Beneficiaries | 1519 |
| Number Of Male Beneficiaries | 979 |
| Number Of Non Hispanic White Beneficiaries | 1420 |
| Number Of Black or African American Beneficiaries | 422 |
| Number Of AsianPacific Islander Beneficiaries | 265 |
| Number Of Hispanic Beneficiaries | 343 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1565 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 933 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| 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 | 40 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.926 |