| National Provider Identifier [NPI]: | 1407822240 |
| Last Name Of The Provider | SHARIATI |
| First Name Of The Provider | ALI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1600 LAKELAND HILLS BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAKELAND |
| Zip Code Of The Provider | 33805 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 210 |
| Number Of Services | 14779 |
| Number Of Medicare Beneficiaries | 3892 |
| Total Submitted Charge Amount | 1713541 |
| Total Medicare Allowed Amount | 593951.34 |
| Total Medicare Payment Amount | 467585.14 |
| Total Medicare Standardized Payment Amount | 485394.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 8658 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 18255 |
| Total Drug Medicare AllowedAmount | 4015.6 |
| Total Drug Medicare PaymentAmount | 3123.27 |
| Total Drug Medicare Standardized Payment Amount | 3123.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 206 |
| Number Of Medical Services | 6121 |
| Number Of Medicare Beneficiaries With Medical Services | 3890 |
| Total Medical Submitted Charge Amount | 1695286 |
| Total Medical Medicare Allowed Amount | 589935.74 |
| Total Medical Medicare Payment Amount | 464461.87 |
| Total Medical Medicare Standardized Payment Amount | 482271.57 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 389 |
| Number Of Beneficiaries Age 65 to 74 | 1464 |
| Number Of Beneficiaries Age 75 to 84 | 1383 |
| Number Of Beneficiaries Age Greater 84 | 656 |
| Number Of Female Beneficiaries | 2475 |
| Number Of Male Beneficiaries | 1417 |
| Number Of Non Hispanic White Beneficiaries | 3475 |
| Number Of Black or African American Beneficiaries | 234 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 139 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3286 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 606 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4689 |