| National Provider Identifier [NPI]: | 1700103132 |
| Last Name Of The Provider | FABELA |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 929 HILLTOP DR |
| Street Address 2 Of The Provider | WEATHERFORD PRIMARY CARE |
| City Of The Provider | WEATHERFORD |
| Zip Code Of The Provider | 76086 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 2594 |
| Number Of Medicare Beneficiaries | 501 |
| Total Submitted Charge Amount | 569807 |
| Total Medicare Allowed Amount | 226876.26 |
| Total Medicare Payment Amount | 162491.89 |
| Total Medicare Standardized Payment Amount | 174101.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 185 |
| Number Of Medicare Beneficiaries With Drug Services | 144 |
| Total Drug Submitted ChargeAmount | 9423 |
| Total Drug Medicare AllowedAmount | 2946.5 |
| Total Drug Medicare PaymentAmount | 2834.44 |
| Total Drug Medicare Standardized Payment Amount | 2834.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 2409 |
| Number Of Medicare Beneficiaries With Medical Services | 501 |
| Total Medical Submitted Charge Amount | 560384 |
| Total Medical Medicare Allowed Amount | 223929.76 |
| Total Medical Medicare Payment Amount | 159657.45 |
| Total Medical Medicare Standardized Payment Amount | 171267.11 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 81 |
| Number Of Beneficiaries Age 65 to 74 | 220 |
| Number Of Beneficiaries Age 75 to 84 | 135 |
| Number Of Beneficiaries Age Greater 84 | 65 |
| Number Of Female Beneficiaries | 300 |
| Number Of Male Beneficiaries | 201 |
| Number Of Non Hispanic White Beneficiaries | 455 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 402 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 99 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3387 |