| National Provider Identifier [NPI]: | 1306812805 |
| Last Name Of The Provider | SAHAGUN |
| First Name Of The Provider | OMAR |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5455 WILSHIRE BLVD |
| Street Address 2 Of The Provider | SUITE 1120 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900364201 |
| 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 | 170 |
| Number Of Services | 6714 |
| Number Of Medicare Beneficiaries | 2686 |
| Total Submitted Charge Amount | 985182.5 |
| Total Medicare Allowed Amount | 236558.18 |
| Total Medicare Payment Amount | 176075.48 |
| Total Medicare Standardized Payment Amount | 162728.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1849 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 3277.5 |
| Total Drug Medicare AllowedAmount | 681.12 |
| Total Drug Medicare PaymentAmount | 533.97 |
| Total Drug Medicare Standardized Payment Amount | 533.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 165 |
| Number Of Medical Services | 4865 |
| Number Of Medicare Beneficiaries With Medical Services | 2686 |
| Total Medical Submitted Charge Amount | 981905 |
| Total Medical Medicare Allowed Amount | 235877.06 |
| Total Medical Medicare Payment Amount | 175541.51 |
| Total Medical Medicare Standardized Payment Amount | 162194.17 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 335 |
| Number Of Beneficiaries Age 65 to 74 | 899 |
| Number Of Beneficiaries Age 75 to 84 | 841 |
| Number Of Beneficiaries Age Greater 84 | 611 |
| Number Of Female Beneficiaries | 1572 |
| Number Of Male Beneficiaries | 1114 |
| Number Of Non Hispanic White Beneficiaries | 2050 |
| Number Of Black or African American Beneficiaries | 128 |
| Number Of AsianPacific Islander Beneficiaries | 154 |
| Number Of Hispanic Beneficiaries | 313 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1928 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 758 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8867 |