National Provider Identifier [NPI]: |
1265438105 |
Last Name Of The Provider |
SOTO |
First Name Of The Provider |
ALFRED |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1580 SANTA BARBARA BLVD |
Street Address 2 Of The Provider |
SUITE C |
City Of The Provider |
THE VILLAGES |
Zip Code Of The Provider |
321596827 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
910 |
Number Of Medicare Beneficiaries |
287 |
Total Submitted Charge Amount |
106375.03 |
Total Medicare Allowed Amount |
75652 |
Total Medicare Payment Amount |
56661.62 |
Total Medicare Standardized Payment Amount |
57151.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
38 |
Number Of Medicare Beneficiaries With Drug Services |
30 |
Total Drug Submitted ChargeAmount |
1290 |
Total Drug Medicare AllowedAmount |
767.75 |
Total Drug Medicare PaymentAmount |
748.74 |
Total Drug Medicare Standardized Payment Amount |
748.74 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
58 |
Number Of Medical Services |
872 |
Number Of Medicare Beneficiaries With Medical Services |
287 |
Total Medical Submitted Charge Amount |
105085.03 |
Total Medical Medicare Allowed Amount |
74884.25 |
Total Medical Medicare Payment Amount |
55912.88 |
Total Medical Medicare Standardized Payment Amount |
56402.36 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
139 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
162 |
Number Of Male Beneficiaries |
125 |
Number Of Non Hispanic White Beneficiaries |
251 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
251 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2538 |