| National Provider Identifier [NPI]: | 1184888323 |
| Last Name Of The Provider | MOTAMEDI |
| First Name Of The Provider | DARIA |
| 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 | 200 W ARBOR DR |
| Street Address 2 Of The Provider | MAIL CODE 0834 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921039001 |
| 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 | 110 |
| Number Of Services | 4497 |
| Number Of Medicare Beneficiaries | 2664 |
| Total Submitted Charge Amount | 1149220 |
| Total Medicare Allowed Amount | 88978.14 |
| Total Medicare Payment Amount | 68965.08 |
| Total Medicare Standardized Payment Amount | 64734.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 110 |
| Number Of Medical Services | 4497 |
| Number Of Medicare Beneficiaries With Medical Services | 2664 |
| Total Medical Submitted Charge Amount | 1149220 |
| Total Medical Medicare Allowed Amount | 88978.14 |
| Total Medical Medicare Payment Amount | 68965.08 |
| Total Medical Medicare Standardized Payment Amount | 64734.41 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 519 |
| Number Of Beneficiaries Age 65 to 74 | 1302 |
| Number Of Beneficiaries Age 75 to 84 | 614 |
| Number Of Beneficiaries Age Greater 84 | 229 |
| Number Of Female Beneficiaries | 1705 |
| Number Of Male Beneficiaries | 959 |
| Number Of Non Hispanic White Beneficiaries | 1755 |
| Number Of Black or African American Beneficiaries | 217 |
| Number Of AsianPacific Islander Beneficiaries | 386 |
| Number Of Hispanic Beneficiaries | 220 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1698 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 966 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.397 |