| National Provider Identifier [NPI]: | 1922198092 |
| Last Name Of The Provider | MODABBER |
| First Name Of The Provider | M |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2020 SANTA MONICA BLVD STE 400 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANTA MONICA |
| Zip Code Of The Provider | 904042139 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 979 |
| Number Of Medicare Beneficiaries | 320 |
| Total Submitted Charge Amount | 375223.08 |
| Total Medicare Allowed Amount | 92844.08 |
| Total Medicare Payment Amount | 71815.07 |
| Total Medicare Standardized Payment Amount | 68229.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 89 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 1225 |
| Total Drug Medicare AllowedAmount | 110.05 |
| Total Drug Medicare PaymentAmount | 86.3 |
| Total Drug Medicare Standardized Payment Amount | 86.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 890 |
| Number Of Medicare Beneficiaries With Medical Services | 320 |
| Total Medical Submitted Charge Amount | 373998.08 |
| Total Medical Medicare Allowed Amount | 92734.03 |
| Total Medical Medicare Payment Amount | 71728.77 |
| Total Medical Medicare Standardized Payment Amount | 68143.46 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 168 |
| Number Of Beneficiaries Age 75 to 84 | 102 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 182 |
| Number Of Male Beneficiaries | 138 |
| Number Of Non Hispanic White Beneficiaries | 277 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 289 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0899 |