| National Provider Identifier [NPI]: | 1396931861 |
| Last Name Of The Provider | SABAEVA |
| First Name Of The Provider | ELENA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 560 W MACPHAIL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEL AIR |
| Zip Code Of The Provider | 210144320 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 1260 |
| Number Of Medicare Beneficiaries | 395 |
| Total Submitted Charge Amount | 116812 |
| Total Medicare Allowed Amount | 49970.43 |
| Total Medicare Payment Amount | 36028.35 |
| Total Medicare Standardized Payment Amount | 34841.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 109 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 937 |
| Total Drug Medicare AllowedAmount | 218.45 |
| Total Drug Medicare PaymentAmount | 172.39 |
| Total Drug Medicare Standardized Payment Amount | 172.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 1151 |
| Number Of Medicare Beneficiaries With Medical Services | 395 |
| Total Medical Submitted Charge Amount | 115875 |
| Total Medical Medicare Allowed Amount | 49751.98 |
| Total Medical Medicare Payment Amount | 35855.96 |
| Total Medical Medicare Standardized Payment Amount | 34669.26 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 193 |
| Number Of Beneficiaries Age 75 to 84 | 106 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 269 |
| Number Of Male Beneficiaries | 126 |
| Number Of Non Hispanic White Beneficiaries | 335 |
| Number Of Black or African American Beneficiaries | 49 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 355 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0159 |