| National Provider Identifier [NPI]: | 1821011578 |
| Last Name Of The Provider | IBRAHIM |
| First Name Of The Provider | MOHAMED |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 609 E ORANGEBURG AVE |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | MODESTO |
| Zip Code Of The Provider | 953505512 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hand Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 101 |
| Number Of Services | 955 |
| Number Of Medicare Beneficiaries | 176 |
| Total Submitted Charge Amount | 294626.11 |
| Total Medicare Allowed Amount | 123043.37 |
| Total Medicare Payment Amount | 94252.12 |
| Total Medicare Standardized Payment Amount | 87859.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 185 |
| Number Of Medicare Beneficiaries With Drug Services | 63 |
| Total Drug Submitted ChargeAmount | 617.45 |
| Total Drug Medicare AllowedAmount | 333.54 |
| Total Drug Medicare PaymentAmount | 250.65 |
| Total Drug Medicare Standardized Payment Amount | 250.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 99 |
| Number Of Medical Services | 770 |
| Number Of Medicare Beneficiaries With Medical Services | 176 |
| Total Medical Submitted Charge Amount | 294008.66 |
| Total Medical Medicare Allowed Amount | 122709.83 |
| Total Medical Medicare Payment Amount | 94001.47 |
| Total Medical Medicare Standardized Payment Amount | 87609 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 79 |
| Number Of Beneficiaries Age 75 to 84 | 33 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 105 |
| Number Of Male Beneficiaries | 71 |
| Number Of Non Hispanic White Beneficiaries | 125 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 103 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 73 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1068 |