| National Provider Identifier [NPI]: | 1558395905 |
| Last Name Of The Provider | SABNIS |
| First Name Of The Provider | ETHEL |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3003 W GOOD HOPE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MILWAUKEE |
| Zip Code Of The Provider | 532092042 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 134 |
| Number Of Services | 11958 |
| Number Of Medicare Beneficiaries | 1881 |
| Total Submitted Charge Amount | 2293488 |
| Total Medicare Allowed Amount | 244368.63 |
| Total Medicare Payment Amount | 190042.28 |
| Total Medicare Standardized Payment Amount | 203118.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 9126 |
| Number Of Medicare Beneficiaries With Drug Services | 106 |
| Total Drug Submitted ChargeAmount | 21129 |
| Total Drug Medicare AllowedAmount | 2499.04 |
| Total Drug Medicare PaymentAmount | 1916.28 |
| Total Drug Medicare Standardized Payment Amount | 1916.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 130 |
| Number Of Medical Services | 2832 |
| Number Of Medicare Beneficiaries With Medical Services | 1881 |
| Total Medical Submitted Charge Amount | 2272359 |
| Total Medical Medicare Allowed Amount | 241869.59 |
| Total Medical Medicare Payment Amount | 188126 |
| Total Medical Medicare Standardized Payment Amount | 201201.91 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 260 |
| Number Of Beneficiaries Age 65 to 74 | 834 |
| Number Of Beneficiaries Age 75 to 84 | 538 |
| Number Of Beneficiaries Age Greater 84 | 249 |
| Number Of Female Beneficiaries | 1345 |
| Number Of Male Beneficiaries | 536 |
| Number Of Non Hispanic White Beneficiaries | 1437 |
| Number Of Black or African American Beneficiaries | 360 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1602 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 279 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1192 |