| National Provider Identifier [NPI]: | 1225271455 |
| Last Name Of The Provider | ESFANDI |
| First Name Of The Provider | SIAMAC |
| 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 | 2100 KEYSTONE AVE |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | DREXEL HILL |
| Zip Code Of The Provider | 190261129 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 1281 |
| Number Of Medicare Beneficiaries | 259 |
| Total Submitted Charge Amount | 101356 |
| Total Medicare Allowed Amount | 57758.98 |
| Total Medicare Payment Amount | 42550.52 |
| Total Medicare Standardized Payment Amount | 40545.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 804 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 26730 |
| Total Drug Medicare AllowedAmount | 13706.35 |
| Total Drug Medicare PaymentAmount | 10744.45 |
| Total Drug Medicare Standardized Payment Amount | 10744.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 477 |
| Number Of Medicare Beneficiaries With Medical Services | 259 |
| Total Medical Submitted Charge Amount | 74626 |
| Total Medical Medicare Allowed Amount | 44052.63 |
| Total Medical Medicare Payment Amount | 31806.07 |
| Total Medical Medicare Standardized Payment Amount | 29801.32 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 144 |
| Number Of Beneficiaries Age 65 to 74 | 69 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 177 |
| Number Of Male Beneficiaries | 82 |
| Number Of Non Hispanic White Beneficiaries | 141 |
| Number Of Black or African American Beneficiaries | 80 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 106 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 153 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 22 |
| Average HCC Risk Score Of Beneficiaries | 2.2684 |