| National Provider Identifier [NPI]: | 1578527388 |
| Last Name Of The Provider | SOSTOK |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 222 PIEDMONT AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CINCINNATI |
| Zip Code Of The Provider | 45219 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 551 |
| Number Of Medicare Beneficiaries | 161 |
| Total Submitted Charge Amount | 92207 |
| Total Medicare Allowed Amount | 38388.71 |
| Total Medicare Payment Amount | 27128.4 |
| Total Medicare Standardized Payment Amount | 28464.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 1438 |
| Total Drug Medicare AllowedAmount | 974.41 |
| Total Drug Medicare PaymentAmount | 954.85 |
| Total Drug Medicare Standardized Payment Amount | 954.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 517 |
| Number Of Medicare Beneficiaries With Medical Services | 161 |
| Total Medical Submitted Charge Amount | 90769 |
| Total Medical Medicare Allowed Amount | 37414.3 |
| Total Medical Medicare Payment Amount | 26173.55 |
| Total Medical Medicare Standardized Payment Amount | 27509.97 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 63 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 76 |
| Number Of Male Beneficiaries | 85 |
| Number Of Non Hispanic White Beneficiaries | 99 |
| 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 | 115 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6108 |