| National Provider Identifier [NPI]: | 1497836159 |
| Last Name Of The Provider | SUMABAT |
| First Name Of The Provider | ALWYN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 710 N EUCLID ST |
| Street Address 2 Of The Provider | SUITE 107 |
| City Of The Provider | ANAHEIM |
| Zip Code Of The Provider | 928014115 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 861 |
| Number Of Medicare Beneficiaries | 180 |
| Total Submitted Charge Amount | 72877 |
| Total Medicare Allowed Amount | 35734.11 |
| Total Medicare Payment Amount | 26143.76 |
| Total Medicare Standardized Payment Amount | 24238.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 79 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 1777 |
| Total Drug Medicare AllowedAmount | 407.02 |
| Total Drug Medicare PaymentAmount | 389.82 |
| Total Drug Medicare Standardized Payment Amount | 389.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 782 |
| Number Of Medicare Beneficiaries With Medical Services | 180 |
| Total Medical Submitted Charge Amount | 71100 |
| Total Medical Medicare Allowed Amount | 35327.09 |
| Total Medical Medicare Payment Amount | 25753.94 |
| Total Medical Medicare Standardized Payment Amount | 23848.27 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 79 |
| Number Of Beneficiaries Age 75 to 84 | 44 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 115 |
| Number Of Male Beneficiaries | 65 |
| Number Of Non Hispanic White Beneficiaries | 85 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 127 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1041 |