| National Provider Identifier [NPI]: | 1659578300 |
| Last Name Of The Provider | SEBATA |
| First Name Of The Provider | HENRY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 S RAYMOND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALHAMBRA |
| Zip Code Of The Provider | 918013166 |
| 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 | 151 |
| Number Of Services | 4854 |
| Number Of Medicare Beneficiaries | 1879 |
| Total Submitted Charge Amount | 494003 |
| Total Medicare Allowed Amount | 139145.29 |
| Total Medicare Payment Amount | 103313.45 |
| Total Medicare Standardized Payment Amount | 96420.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1166 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 5712 |
| Total Drug Medicare AllowedAmount | 663.1 |
| Total Drug Medicare PaymentAmount | 519.83 |
| Total Drug Medicare Standardized Payment Amount | 519.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 149 |
| Number Of Medical Services | 3688 |
| Number Of Medicare Beneficiaries With Medical Services | 1879 |
| Total Medical Submitted Charge Amount | 488291 |
| Total Medical Medicare Allowed Amount | 138482.19 |
| Total Medical Medicare Payment Amount | 102793.62 |
| Total Medical Medicare Standardized Payment Amount | 95900.63 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 219 |
| Number Of Beneficiaries Age 65 to 74 | 430 |
| Number Of Beneficiaries Age 75 to 84 | 593 |
| Number Of Beneficiaries Age Greater 84 | 637 |
| Number Of Female Beneficiaries | 1032 |
| Number Of Male Beneficiaries | 847 |
| Number Of Non Hispanic White Beneficiaries | 311 |
| Number Of Black or African American Beneficiaries | 95 |
| Number Of AsianPacific Islander Beneficiaries | 975 |
| Number Of Hispanic Beneficiaries | 468 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 356 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1523 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 47 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 60 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 50 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 63 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 24 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 2.9959 |