| National Provider Identifier [NPI]: | 1750472825 |
| Last Name Of The Provider | SABEAN |
| First Name Of The Provider | JOEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 350 COTTAGE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTH PORTLAND |
| Zip Code Of The Provider | 04106 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 3119 |
| Number Of Medicare Beneficiaries | 655 |
| Total Submitted Charge Amount | 354536 |
| Total Medicare Allowed Amount | 152776.26 |
| Total Medicare Payment Amount | 108372.13 |
| Total Medicare Standardized Payment Amount | 107664.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 8432 |
| Total Drug Medicare AllowedAmount | 8346.5 |
| Total Drug Medicare PaymentAmount | 6540.25 |
| Total Drug Medicare Standardized Payment Amount | 6540.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 3085 |
| Number Of Medicare Beneficiaries With Medical Services | 655 |
| Total Medical Submitted Charge Amount | 346104 |
| Total Medical Medicare Allowed Amount | 144429.76 |
| Total Medical Medicare Payment Amount | 101831.88 |
| Total Medical Medicare Standardized Payment Amount | 101124.42 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 293 |
| Number Of Beneficiaries Age 75 to 84 | 212 |
| Number Of Beneficiaries Age Greater 84 | 98 |
| Number Of Female Beneficiaries | 384 |
| Number Of Male Beneficiaries | 271 |
| Number Of Non Hispanic White Beneficiaries | 638 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 596 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.9146 |