| National Provider Identifier [NPI]: | 1811002777 |
| Last Name Of The Provider | BANOONI |
| First Name Of The Provider | PEYMAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 N ROBERTSON BLVD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | BEVERLY HILLS |
| Zip Code Of The Provider | 902112142 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Obstetrics/Gynecology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 691 |
| Number Of Medicare Beneficiaries | 162 |
| Total Submitted Charge Amount | 113704 |
| Total Medicare Allowed Amount | 50244.76 |
| Total Medicare Payment Amount | 38059.89 |
| Total Medicare Standardized Payment Amount | 35761.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 17 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 445 |
| Total Drug Medicare AllowedAmount | 35.11 |
| Total Drug Medicare PaymentAmount | 11.81 |
| Total Drug Medicare Standardized Payment Amount | 11.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 674 |
| Number Of Medicare Beneficiaries With Medical Services | 162 |
| Total Medical Submitted Charge Amount | 113259 |
| Total Medical Medicare Allowed Amount | 50209.65 |
| Total Medical Medicare Payment Amount | 38048.08 |
| Total Medical Medicare Standardized Payment Amount | 35749.42 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 82 |
| Number Of Beneficiaries Age 75 to 84 | 32 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 143 |
| Number Of Male Beneficiaries | 19 |
| Number Of Non Hispanic White Beneficiaries | 68 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 72 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 90 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3778 |