| National Provider Identifier [NPI]: | 1952342883 |
| Last Name Of The Provider | JABOLA |
| First Name Of The Provider | R |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 COFFEE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MODESTO |
| Zip Code Of The Provider | 953554201 |
| 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 | 118 |
| Number Of Services | 12973 |
| Number Of Medicare Beneficiaries | 4252 |
| Total Submitted Charge Amount | 1055989.42 |
| Total Medicare Allowed Amount | 222959.68 |
| Total Medicare Payment Amount | 164892.96 |
| Total Medicare Standardized Payment Amount | 158536.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 6025 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 7893.42 |
| Total Drug Medicare AllowedAmount | 1566.16 |
| Total Drug Medicare PaymentAmount | 1227.86 |
| Total Drug Medicare Standardized Payment Amount | 1227.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 114 |
| Number Of Medical Services | 6948 |
| Number Of Medicare Beneficiaries With Medical Services | 4251 |
| Total Medical Submitted Charge Amount | 1048096 |
| Total Medical Medicare Allowed Amount | 221393.52 |
| Total Medical Medicare Payment Amount | 163665.1 |
| Total Medical Medicare Standardized Payment Amount | 157308.8 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 916 |
| Number Of Beneficiaries Age 65 to 74 | 1515 |
| Number Of Beneficiaries Age 75 to 84 | 1132 |
| Number Of Beneficiaries Age Greater 84 | 689 |
| Number Of Female Beneficiaries | 2456 |
| Number Of Male Beneficiaries | 1796 |
| Number Of Non Hispanic White Beneficiaries | 2994 |
| Number Of Black or African American Beneficiaries | 181 |
| Number Of AsianPacific Islander Beneficiaries | 206 |
| Number Of Hispanic Beneficiaries | 789 |
| Number Of American Indian Alaska Native Beneficiaries | 24 |
| Number Of Beneficiaries With Race Not Else where Classified | 58 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2427 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1825 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8377 |