| National Provider Identifier [NPI]: | 1437118429 |
| Last Name Of The Provider | MIRFAKHRAEE |
| First Name Of The Provider | MONSOUR |
| 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 | 2600 GREENWOOD RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHREVEPORT |
| Zip Code Of The Provider | 711033908 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 232 |
| Number Of Services | 6351 |
| Number Of Medicare Beneficiaries | 3923 |
| Total Submitted Charge Amount | 855548.63 |
| Total Medicare Allowed Amount | 209504.85 |
| Total Medicare Payment Amount | 158600.34 |
| Total Medicare Standardized Payment Amount | 165470.02 |
| 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 | 232 |
| Number Of Medical Services | 6351 |
| Number Of Medicare Beneficiaries With Medical Services | 3923 |
| Total Medical Submitted Charge Amount | 855548.63 |
| Total Medical Medicare Allowed Amount | 209504.85 |
| Total Medical Medicare Payment Amount | 158600.34 |
| Total Medical Medicare Standardized Payment Amount | 165470.02 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 649 |
| Number Of Beneficiaries Age 65 to 74 | 1422 |
| Number Of Beneficiaries Age 75 to 84 | 1260 |
| Number Of Beneficiaries Age Greater 84 | 592 |
| Number Of Female Beneficiaries | 2443 |
| Number Of Male Beneficiaries | 1480 |
| Number Of Non Hispanic White Beneficiaries | 2899 |
| Number Of Black or African American Beneficiaries | 934 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2909 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1014 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.905 |