| National Provider Identifier [NPI]: | 1316934664 |
| Last Name Of The Provider | SOUDER |
| First Name Of The Provider | BOB |
| 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 | 9 PHYSICIANS DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 383052071 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 125 |
| Number Of Services | 44723 |
| Number Of Medicare Beneficiaries | 2988 |
| Total Submitted Charge Amount | 3274191 |
| Total Medicare Allowed Amount | 1145118.9 |
| Total Medicare Payment Amount | 869328.12 |
| Total Medicare Standardized Payment Amount | 947103.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 23771 |
| Number Of Medicare Beneficiaries With Drug Services | 241 |
| Total Drug Submitted ChargeAmount | 24520 |
| Total Drug Medicare AllowedAmount | 4536.06 |
| Total Drug Medicare PaymentAmount | 3526.06 |
| Total Drug Medicare Standardized Payment Amount | 3526.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 116 |
| Number Of Medical Services | 20952 |
| Number Of Medicare Beneficiaries With Medical Services | 2988 |
| Total Medical Submitted Charge Amount | 3249671 |
| Total Medical Medicare Allowed Amount | 1140582.84 |
| Total Medical Medicare Payment Amount | 865802.06 |
| Total Medical Medicare Standardized Payment Amount | 943577.85 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 872 |
| Number Of Beneficiaries Age 65 to 74 | 1228 |
| Number Of Beneficiaries Age 75 to 84 | 686 |
| Number Of Beneficiaries Age Greater 84 | 202 |
| Number Of Female Beneficiaries | 1846 |
| Number Of Male Beneficiaries | 1142 |
| Number Of Non Hispanic White Beneficiaries | 2204 |
| Number Of Black or African American Beneficiaries | 747 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1919 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1069 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4226 |