| National Provider Identifier [NPI]: | 1124214028 |
| Last Name Of The Provider | GHANOUNI |
| First Name Of The Provider | PEJMAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D., PH.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 PASTEUR DR |
| Street Address 2 Of The Provider | STANFORD MED CTR, RADIOLOGY DEPT, RM H-1302F |
| City Of The Provider | STANFORD |
| Zip Code Of The Provider | 943052200 |
| 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 | 76 |
| Number Of Services | 1677 |
| Number Of Medicare Beneficiaries | 1130 |
| Total Submitted Charge Amount | 474485 |
| Total Medicare Allowed Amount | 102646.61 |
| Total Medicare Payment Amount | 73809.52 |
| Total Medicare Standardized Payment Amount | 66933.09 |
| 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 | 76 |
| Number Of Medical Services | 1677 |
| Number Of Medicare Beneficiaries With Medical Services | 1130 |
| Total Medical Submitted Charge Amount | 474485 |
| Total Medical Medicare Allowed Amount | 102646.61 |
| Total Medical Medicare Payment Amount | 73809.52 |
| Total Medical Medicare Standardized Payment Amount | 66933.09 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 203 |
| Number Of Beneficiaries Age 65 to 74 | 471 |
| Number Of Beneficiaries Age 75 to 84 | 308 |
| Number Of Beneficiaries Age Greater 84 | 148 |
| Number Of Female Beneficiaries | 585 |
| Number Of Male Beneficiaries | 545 |
| Number Of Non Hispanic White Beneficiaries | 687 |
| Number Of Black or African American Beneficiaries | 54 |
| Number Of AsianPacific Islander Beneficiaries | 203 |
| Number Of Hispanic Beneficiaries | 144 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 792 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 338 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.1192 |