National Provider Identifier [NPI]: |
1548556582 |
Last Name Of The Provider |
SOMAN |
First Name Of The Provider |
AAMOD |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
900 ILLINOIS AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
STEVENS POINT |
Zip Code Of The Provider |
544813114 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
937 |
Number Of Medicare Beneficiaries |
401 |
Total Submitted Charge Amount |
198373.77 |
Total Medicare Allowed Amount |
63424.37 |
Total Medicare Payment Amount |
48656.22 |
Total Medicare Standardized Payment Amount |
50551.8 |
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 |
24 |
Number Of Medical Services |
937 |
Number Of Medicare Beneficiaries With Medical Services |
401 |
Total Medical Submitted Charge Amount |
198373.77 |
Total Medical Medicare Allowed Amount |
63424.37 |
Total Medical Medicare Payment Amount |
48656.22 |
Total Medical Medicare Standardized Payment Amount |
50551.8 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
70 |
Number Of Beneficiaries Age 65 to 74 |
107 |
Number Of Beneficiaries Age 75 to 84 |
110 |
Number Of Beneficiaries Age Greater 84 |
114 |
Number Of Female Beneficiaries |
207 |
Number Of Male Beneficiaries |
194 |
Number Of Non Hispanic White Beneficiaries |
384 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
257 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
144 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.843 |