National Provider Identifier [NPI]: |
1760521660 |
Last Name Of The Provider |
SONNEMAKER |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1235 E CHEROKEE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658042203 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nuclear Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
2512 |
Number Of Medicare Beneficiaries |
2095 |
Total Submitted Charge Amount |
459412 |
Total Medicare Allowed Amount |
94365.03 |
Total Medicare Payment Amount |
73451.88 |
Total Medicare Standardized Payment Amount |
76874.19 |
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 |
38 |
Number Of Medical Services |
2512 |
Number Of Medicare Beneficiaries With Medical Services |
2095 |
Total Medical Submitted Charge Amount |
459412 |
Total Medical Medicare Allowed Amount |
94365.03 |
Total Medical Medicare Payment Amount |
73451.88 |
Total Medical Medicare Standardized Payment Amount |
76874.19 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
304 |
Number Of Beneficiaries Age 65 to 74 |
981 |
Number Of Beneficiaries Age 75 to 84 |
597 |
Number Of Beneficiaries Age Greater 84 |
213 |
Number Of Female Beneficiaries |
1504 |
Number Of Male Beneficiaries |
591 |
Number Of Non Hispanic White Beneficiaries |
2040 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1743 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
352 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
19 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.3414 |