National Provider Identifier [NPI]: |
1275614224 |
Last Name Of The Provider |
SONDA |
First Name Of The Provider |
L |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 EAST MEDICAL CENTER DR |
Street Address 2 Of The Provider |
B1 FLOOR UNIVERSITY HOSPITAL RECP C |
City Of The Provider |
ANN ARBOR |
Zip Code Of The Provider |
481095030 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
1743 |
Number Of Medicare Beneficiaries |
1255 |
Total Submitted Charge Amount |
188020 |
Total Medicare Allowed Amount |
38724.92 |
Total Medicare Payment Amount |
29037.7 |
Total Medicare Standardized Payment Amount |
28184.65 |
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 |
39 |
Number Of Medical Services |
1743 |
Number Of Medicare Beneficiaries With Medical Services |
1255 |
Total Medical Submitted Charge Amount |
188020 |
Total Medical Medicare Allowed Amount |
38724.92 |
Total Medical Medicare Payment Amount |
29037.7 |
Total Medical Medicare Standardized Payment Amount |
28184.65 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
384 |
Number Of Beneficiaries Age 65 to 74 |
493 |
Number Of Beneficiaries Age 75 to 84 |
270 |
Number Of Beneficiaries Age Greater 84 |
108 |
Number Of Female Beneficiaries |
656 |
Number Of Male Beneficiaries |
599 |
Number Of Non Hispanic White Beneficiaries |
1010 |
Number Of Black or African American Beneficiaries |
156 |
Number Of AsianPacific Islander Beneficiaries |
29 |
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
875 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
380 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
51 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.4104 |