National Provider Identifier [NPI]: |
1639495971 |
Last Name Of The Provider |
SONANI |
First Name Of The Provider |
BHAVIN |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
800 E CARPENTER ST |
Street Address 2 Of The Provider |
ST. JOHN'S HOSPITAL |
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
627025324 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
1067 |
Number Of Medicare Beneficiaries |
445 |
Total Submitted Charge Amount |
216417 |
Total Medicare Allowed Amount |
112953.36 |
Total Medicare Payment Amount |
87815.81 |
Total Medicare Standardized Payment Amount |
89471.59 |
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 |
20 |
Number Of Medical Services |
1067 |
Number Of Medicare Beneficiaries With Medical Services |
445 |
Total Medical Submitted Charge Amount |
216417 |
Total Medical Medicare Allowed Amount |
112953.36 |
Total Medical Medicare Payment Amount |
87815.81 |
Total Medical Medicare Standardized Payment Amount |
89471.59 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
133 |
Number Of Beneficiaries Age 75 to 84 |
139 |
Number Of Beneficiaries Age Greater 84 |
104 |
Number Of Female Beneficiaries |
210 |
Number Of Male Beneficiaries |
235 |
Number Of Non Hispanic White Beneficiaries |
427 |
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 |
307 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
138 |
Percent Of With Atrial Fibrillation |
32 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
64 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
40 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.1077 |