National Provider Identifier [NPI]: |
1376571497 |
Last Name Of The Provider |
SONIN |
First Name Of The Provider |
LEE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
455 S ROSELLE RD |
Street Address 2 Of The Provider |
SUITE 206 |
City Of The Provider |
SCHAUMBURG |
Zip Code Of The Provider |
601932971 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Allergy/Immunology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
3361 |
Number Of Medicare Beneficiaries |
203 |
Total Submitted Charge Amount |
77681 |
Total Medicare Allowed Amount |
55077.2 |
Total Medicare Payment Amount |
40550.55 |
Total Medicare Standardized Payment Amount |
38824.67 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
17 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
340 |
Total Drug Medicare AllowedAmount |
204.68 |
Total Drug Medicare PaymentAmount |
200.6 |
Total Drug Medicare Standardized Payment Amount |
200.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
3344 |
Number Of Medicare Beneficiaries With Medical Services |
203 |
Total Medical Submitted Charge Amount |
77341 |
Total Medical Medicare Allowed Amount |
54872.52 |
Total Medical Medicare Payment Amount |
40349.95 |
Total Medical Medicare Standardized Payment Amount |
38624.07 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
134 |
Number Of Male Beneficiaries |
69 |
Number Of Non Hispanic White Beneficiaries |
183 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
178 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
28 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8549 |