| National Provider Identifier [NPI]: | 1538269535 |
| Last Name Of The Provider | SOSA |
| First Name Of The Provider | HUMBERTO |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 CRESTWOOD CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MENA |
| Zip Code Of The Provider | 719535515 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 1139 |
| Number Of Medicare Beneficiaries | 705 |
| Total Submitted Charge Amount | 55410.48 |
| Total Medicare Allowed Amount | 21564.52 |
| Total Medicare Payment Amount | 16775.77 |
| Total Medicare Standardized Payment Amount | 17266.85 |
| 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 | 7 |
| Number Of Medical Services | 1139 |
| Number Of Medicare Beneficiaries With Medical Services | 705 |
| Total Medical Submitted Charge Amount | 55410.48 |
| Total Medical Medicare Allowed Amount | 21564.52 |
| Total Medical Medicare Payment Amount | 16775.77 |
| Total Medical Medicare Standardized Payment Amount | 17266.85 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 100 |
| Number Of Beneficiaries Age 65 to 74 | 252 |
| Number Of Beneficiaries Age 75 to 84 | 239 |
| Number Of Beneficiaries Age Greater 84 | 114 |
| Number Of Female Beneficiaries | 414 |
| Number Of Male Beneficiaries | 291 |
| Number Of Non Hispanic White Beneficiaries | 685 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 475 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 230 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.3179 |