| National Provider Identifier [NPI]: | 1043257306 |
| Last Name Of The Provider | SOBEK |
| First Name Of The Provider | DANE |
| 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 | 905 HIGHLAND BLVD |
| Street Address 2 Of The Provider | SUITE 4330 |
| City Of The Provider | BOZEMAN |
| Zip Code Of The Provider | 597156902 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 2807 |
| Number Of Medicare Beneficiaries | 1228 |
| Total Submitted Charge Amount | 476629 |
| Total Medicare Allowed Amount | 169891.28 |
| Total Medicare Payment Amount | 126940.37 |
| Total Medicare Standardized Payment Amount | 125831.1 |
| 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 | 62 |
| Number Of Medical Services | 2807 |
| Number Of Medicare Beneficiaries With Medical Services | 1228 |
| Total Medical Submitted Charge Amount | 476629 |
| Total Medical Medicare Allowed Amount | 169891.28 |
| Total Medical Medicare Payment Amount | 126940.37 |
| Total Medical Medicare Standardized Payment Amount | 125831.1 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 101 |
| Number Of Beneficiaries Age 65 to 74 | 464 |
| Number Of Beneficiaries Age 75 to 84 | 410 |
| Number Of Beneficiaries Age Greater 84 | 253 |
| Number Of Female Beneficiaries | 577 |
| Number Of Male Beneficiaries | 651 |
| Number Of Non Hispanic White Beneficiaries | 1182 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1107 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 121 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.225 |