| National Provider Identifier [NPI]: | 1033165360 |
| Last Name Of The Provider | SOROUSH |
| First Name Of The Provider | MEHRDAD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 919 CONESTOGA RD |
| Street Address 2 Of The Provider | BUILDING ONE SUITE 300 |
| City Of The Provider | ROSEMONT |
| Zip Code Of The Provider | 190101352 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 9605 |
| Number Of Medicare Beneficiaries | 1042 |
| Total Submitted Charge Amount | 1550564.55 |
| Total Medicare Allowed Amount | 457409.62 |
| Total Medicare Payment Amount | 341399.52 |
| Total Medicare Standardized Payment Amount | 325795.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 2063 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 121810.15 |
| Total Drug Medicare AllowedAmount | 34407.4 |
| Total Drug Medicare PaymentAmount | 26949.74 |
| Total Drug Medicare Standardized Payment Amount | 26949.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 7542 |
| Number Of Medicare Beneficiaries With Medical Services | 1042 |
| Total Medical Submitted Charge Amount | 1428754.4 |
| Total Medical Medicare Allowed Amount | 423002.22 |
| Total Medical Medicare Payment Amount | 314449.78 |
| Total Medical Medicare Standardized Payment Amount | 298845.97 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 425 |
| Number Of Beneficiaries Age 75 to 84 | 387 |
| Number Of Beneficiaries Age Greater 84 | 188 |
| Number Of Female Beneficiaries | 343 |
| Number Of Male Beneficiaries | 699 |
| Number Of Non Hispanic White Beneficiaries | 961 |
| Number Of Black or African American Beneficiaries | 28 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1008 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2283 |