| National Provider Identifier [NPI]: | 1720191216 |
| Last Name Of The Provider | SOMMERS |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 50 N MEDICAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SALT LAKE CITY |
| Zip Code Of The Provider | 841320001 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 97 |
| Number Of Services | 1841 |
| Number Of Medicare Beneficiaries | 1377 |
| Total Submitted Charge Amount | 273948.56 |
| Total Medicare Allowed Amount | 80554.02 |
| Total Medicare Payment Amount | 58356.72 |
| Total Medicare Standardized Payment Amount | 61555.24 |
| 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 | 97 |
| Number Of Medical Services | 1841 |
| Number Of Medicare Beneficiaries With Medical Services | 1377 |
| Total Medical Submitted Charge Amount | 273948.56 |
| Total Medical Medicare Allowed Amount | 80554.02 |
| Total Medical Medicare Payment Amount | 58356.72 |
| Total Medical Medicare Standardized Payment Amount | 61555.24 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 314 |
| Number Of Beneficiaries Age 65 to 74 | 627 |
| Number Of Beneficiaries Age 75 to 84 | 335 |
| Number Of Beneficiaries Age Greater 84 | 101 |
| Number Of Female Beneficiaries | 665 |
| Number Of Male Beneficiaries | 712 |
| Number Of Non Hispanic White Beneficiaries | 1171 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | 43 |
| Number Of Hispanic Beneficiaries | 100 |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1070 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 307 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.9642 |