| National Provider Identifier [NPI]: | 1043302748 |
| Last Name Of The Provider | KABALIN |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3911 AVENUE B |
| Street Address 2 Of The Provider | SUITE 2200 |
| City Of The Provider | SCOTTSBLUFF |
| Zip Code Of The Provider | 693614617 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 133 |
| Number Of Services | 22899 |
| Number Of Medicare Beneficiaries | 887 |
| Total Submitted Charge Amount | 2014905.42 |
| Total Medicare Allowed Amount | 743839.5 |
| Total Medicare Payment Amount | 566220.54 |
| Total Medicare Standardized Payment Amount | 593230.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 12288 |
| Number Of Medicare Beneficiaries With Drug Services | 157 |
| Total Drug Submitted ChargeAmount | 643276.5 |
| Total Drug Medicare AllowedAmount | 297366.5 |
| Total Drug Medicare PaymentAmount | 231231.91 |
| Total Drug Medicare Standardized Payment Amount | 231231.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 125 |
| Number Of Medical Services | 10611 |
| Number Of Medicare Beneficiaries With Medical Services | 887 |
| Total Medical Submitted Charge Amount | 1371628.92 |
| Total Medical Medicare Allowed Amount | 446473 |
| Total Medical Medicare Payment Amount | 334988.63 |
| Total Medical Medicare Standardized Payment Amount | 361998.59 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 332 |
| Number Of Beneficiaries Age 75 to 84 | 341 |
| Number Of Beneficiaries Age Greater 84 | 158 |
| Number Of Female Beneficiaries | 220 |
| Number Of Male Beneficiaries | 667 |
| Number Of Non Hispanic White Beneficiaries | 817 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 784 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 103 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1311 |