| National Provider Identifier [NPI]: | 1962618462 |
| Last Name Of The Provider | SABLAN |
| First Name Of The Provider | MARIO |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 123 W NORTH BEAR CREEK DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MERCED |
| Zip Code Of The Provider | 953483420 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 152 |
| Number Of Services | 11673 |
| Number Of Medicare Beneficiaries | 1069 |
| Total Submitted Charge Amount | 1418522 |
| Total Medicare Allowed Amount | 788545.79 |
| Total Medicare Payment Amount | 604028.11 |
| Total Medicare Standardized Payment Amount | 592951.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 7288 |
| Number Of Medicare Beneficiaries With Drug Services | 444 |
| Total Drug Submitted ChargeAmount | 69220 |
| Total Drug Medicare AllowedAmount | 49400.02 |
| Total Drug Medicare PaymentAmount | 38562.18 |
| Total Drug Medicare Standardized Payment Amount | 38562.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 150 |
| Number Of Medical Services | 4385 |
| Number Of Medicare Beneficiaries With Medical Services | 1069 |
| Total Medical Submitted Charge Amount | 1349302 |
| Total Medical Medicare Allowed Amount | 739145.77 |
| Total Medical Medicare Payment Amount | 565465.93 |
| Total Medical Medicare Standardized Payment Amount | 554389.33 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 204 |
| Number Of Beneficiaries Age 65 to 74 | 444 |
| Number Of Beneficiaries Age 75 to 84 | 280 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 724 |
| Number Of Male Beneficiaries | 345 |
| Number Of Non Hispanic White Beneficiaries | 602 |
| Number Of Black or African American Beneficiaries | 67 |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| Number Of Hispanic Beneficiaries | 348 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 601 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 468 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 73 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4172 |