National Provider Identifier [NPI]: |
1215215744 |
Last Name Of The Provider |
SORIANO |
First Name Of The Provider |
CHRISTINA |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5665 N JUNCTION WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
DAVIS JUNCTION |
Zip Code Of The Provider |
610209433 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
227 |
Number Of Medicare Beneficiaries |
94 |
Total Submitted Charge Amount |
21923 |
Total Medicare Allowed Amount |
9816 |
Total Medicare Payment Amount |
7494.13 |
Total Medicare Standardized Payment Amount |
7822.2 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
19 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
440 |
Total Drug Medicare AllowedAmount |
251.88 |
Total Drug Medicare PaymentAmount |
238.07 |
Total Drug Medicare Standardized Payment Amount |
238.07 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
208 |
Number Of Medicare Beneficiaries With Medical Services |
94 |
Total Medical Submitted Charge Amount |
21483 |
Total Medical Medicare Allowed Amount |
9564.12 |
Total Medical Medicare Payment Amount |
7256.06 |
Total Medical Medicare Standardized Payment Amount |
7584.13 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
42 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
53 |
Number Of Male Beneficiaries |
41 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.101 |