| National Provider Identifier [NPI]: | 1871547133 |
| Last Name Of The Provider | SUE |
| First Name Of The Provider | DALE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2320 BATH ST |
| Street Address 2 Of The Provider | SUITE 208 |
| City Of The Provider | SANTA BARBARA |
| Zip Code Of The Provider | 931054339 |
| 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 | 145 |
| Number Of Services | 11054 |
| Number Of Medicare Beneficiaries | 2040 |
| Total Submitted Charge Amount | 1152552.56 |
| Total Medicare Allowed Amount | 397513.55 |
| Total Medicare Payment Amount | 327550.66 |
| Total Medicare Standardized Payment Amount | 287749.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 7460 |
| Number Of Medicare Beneficiaries With Drug Services | 147 |
| Total Drug Submitted ChargeAmount | 23944.48 |
| Total Drug Medicare AllowedAmount | 4022.83 |
| Total Drug Medicare PaymentAmount | 2770.94 |
| Total Drug Medicare Standardized Payment Amount | 2770.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 141 |
| Number Of Medical Services | 3594 |
| Number Of Medicare Beneficiaries With Medical Services | 2040 |
| Total Medical Submitted Charge Amount | 1128608.08 |
| Total Medical Medicare Allowed Amount | 393490.72 |
| Total Medical Medicare Payment Amount | 324779.72 |
| Total Medical Medicare Standardized Payment Amount | 284978.63 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 133 |
| Number Of Beneficiaries Age 65 to 74 | 1162 |
| Number Of Beneficiaries Age 75 to 84 | 582 |
| Number Of Beneficiaries Age Greater 84 | 163 |
| Number Of Female Beneficiaries | 1650 |
| Number Of Male Beneficiaries | 390 |
| Number Of Non Hispanic White Beneficiaries | 1711 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 75 |
| Number Of Hispanic Beneficiaries | 167 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 63 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1822 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 218 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9214 |