| National Provider Identifier [NPI]: | 1689679441 |
| Last Name Of The Provider | KHAMAPIRAD |
| First Name Of The Provider | TAWAN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6005 PARK AVE |
| Street Address 2 Of The Provider | STE 624B |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 381195221 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 13033 |
| Number Of Medicare Beneficiaries | 1169 |
| Total Submitted Charge Amount | 4737254.68 |
| Total Medicare Allowed Amount | 2099055.45 |
| Total Medicare Payment Amount | 1598895.94 |
| Total Medicare Standardized Payment Amount | 1649055.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 4069 |
| Number Of Medicare Beneficiaries With Drug Services | 579 |
| Total Drug Submitted ChargeAmount | 1222948.3 |
| Total Drug Medicare AllowedAmount | 1175296.37 |
| Total Drug Medicare PaymentAmount | 913980.81 |
| Total Drug Medicare Standardized Payment Amount | 913980.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 8964 |
| Number Of Medicare Beneficiaries With Medical Services | 1169 |
| Total Medical Submitted Charge Amount | 3514306.38 |
| Total Medical Medicare Allowed Amount | 923759.08 |
| Total Medical Medicare Payment Amount | 684915.13 |
| Total Medical Medicare Standardized Payment Amount | 735074.4 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 156 |
| Number Of Beneficiaries Age 65 to 74 | 407 |
| Number Of Beneficiaries Age 75 to 84 | 382 |
| Number Of Beneficiaries Age Greater 84 | 224 |
| Number Of Female Beneficiaries | 641 |
| Number Of Male Beneficiaries | 528 |
| Number Of Non Hispanic White Beneficiaries | 1037 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 938 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 231 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.557 |