| National Provider Identifier [NPI]: | 1609997402 |
| Last Name Of The Provider | JABOUR |
| First Name Of The Provider | BRADLEY |
| 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 | 2811 WILSHIRE BLVD STE 810 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANTA MONICA |
| Zip Code Of The Provider | 904034812 |
| 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 | 211 |
| Number Of Services | 109676 |
| Number Of Medicare Beneficiaries | 3103 |
| Total Submitted Charge Amount | 11310404.01 |
| Total Medicare Allowed Amount | 1606702.25 |
| Total Medicare Payment Amount | 1261532.36 |
| Total Medicare Standardized Payment Amount | 1154626.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 103003 |
| Number Of Medicare Beneficiaries With Drug Services | 793 |
| Total Drug Submitted ChargeAmount | 769225.01 |
| Total Drug Medicare AllowedAmount | 174365.54 |
| Total Drug Medicare PaymentAmount | 136629.17 |
| Total Drug Medicare Standardized Payment Amount | 136629.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 205 |
| Number Of Medical Services | 6673 |
| Number Of Medicare Beneficiaries With Medical Services | 3103 |
| Total Medical Submitted Charge Amount | 10541179 |
| Total Medical Medicare Allowed Amount | 1432336.71 |
| Total Medical Medicare Payment Amount | 1124903.19 |
| Total Medical Medicare Standardized Payment Amount | 1017997.58 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 210 |
| Number Of Beneficiaries Age 65 to 74 | 1570 |
| Number Of Beneficiaries Age 75 to 84 | 935 |
| Number Of Beneficiaries Age Greater 84 | 388 |
| Number Of Female Beneficiaries | 2006 |
| Number Of Male Beneficiaries | 1097 |
| Number Of Non Hispanic White Beneficiaries | 2560 |
| Number Of Black or African American Beneficiaries | 115 |
| Number Of AsianPacific Islander Beneficiaries | 196 |
| Number Of Hispanic Beneficiaries | 131 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2678 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 425 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.088 |