| National Provider Identifier [NPI]: | 1295912889 |
| Last Name Of The Provider | SABOURIN |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1710 GUNBARREL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHATTANOOGA |
| Zip Code Of The Provider | 374213127 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 143 |
| Number Of Services | 3349 |
| Number Of Medicare Beneficiaries | 2103 |
| Total Submitted Charge Amount | 693906.46 |
| Total Medicare Allowed Amount | 121847.46 |
| Total Medicare Payment Amount | 91374.96 |
| Total Medicare Standardized Payment Amount | 98462.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 143 |
| Number Of Medical Services | 3349 |
| Number Of Medicare Beneficiaries With Medical Services | 2103 |
| Total Medical Submitted Charge Amount | 693906.46 |
| Total Medical Medicare Allowed Amount | 121847.46 |
| Total Medical Medicare Payment Amount | 91374.96 |
| Total Medical Medicare Standardized Payment Amount | 98462.99 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 502 |
| Number Of Beneficiaries Age 65 to 74 | 787 |
| Number Of Beneficiaries Age 75 to 84 | 523 |
| Number Of Beneficiaries Age Greater 84 | 291 |
| Number Of Female Beneficiaries | 1168 |
| Number Of Male Beneficiaries | 935 |
| Number Of Non Hispanic White Beneficiaries | 1830 |
| Number Of Black or African American Beneficiaries | 221 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1378 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 725 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 25 |
| Average HCC Risk Score Of Beneficiaries | 1.8287 |