National Provider Identifier [NPI]: |
1225054463 |
Last Name Of The Provider |
SOTO |
First Name Of The Provider |
PABLO |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
804 E WOODFIELD RD |
Street Address 2 Of The Provider |
STE 300 |
City Of The Provider |
SCHAUMBURG |
Zip Code Of The Provider |
601734776 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
6791 |
Number Of Medicare Beneficiaries |
2310 |
Total Submitted Charge Amount |
2154350 |
Total Medicare Allowed Amount |
875758.03 |
Total Medicare Payment Amount |
676155.48 |
Total Medicare Standardized Payment Amount |
653737.71 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
1029 |
Number Of Medicare Beneficiaries With Drug Services |
258 |
Total Drug Submitted ChargeAmount |
102850 |
Total Drug Medicare AllowedAmount |
54487.63 |
Total Drug Medicare PaymentAmount |
42300.73 |
Total Drug Medicare Standardized Payment Amount |
42300.73 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
5762 |
Number Of Medicare Beneficiaries With Medical Services |
2310 |
Total Medical Submitted Charge Amount |
2051500 |
Total Medical Medicare Allowed Amount |
821270.4 |
Total Medical Medicare Payment Amount |
633854.75 |
Total Medical Medicare Standardized Payment Amount |
611436.98 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
298 |
Number Of Beneficiaries Age 65 to 74 |
797 |
Number Of Beneficiaries Age 75 to 84 |
754 |
Number Of Beneficiaries Age Greater 84 |
461 |
Number Of Female Beneficiaries |
1307 |
Number Of Male Beneficiaries |
1003 |
Number Of Non Hispanic White Beneficiaries |
1430 |
Number Of Black or African American Beneficiaries |
489 |
Number Of AsianPacific Islander Beneficiaries |
193 |
Number Of Hispanic Beneficiaries |
174 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
24 |
Number Of Beneficiaries With Medicare Only Entitlement |
1519 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
791 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
69 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.2295 |