| National Provider Identifier [NPI]: | 1588624209 |
| Last Name Of The Provider | SORENSON |
| First Name Of The Provider | MARLYS |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | CNP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3960 COON RAPIDS BLVD NW |
| Street Address 2 Of The Provider | 100 |
| City Of The Provider | COON RAPIDS |
| Zip Code Of The Provider | 554332569 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 192 |
| Number Of Medicare Beneficiaries | 99 |
| Total Submitted Charge Amount | 6758.3 |
| Total Medicare Allowed Amount | 5417.66 |
| Total Medicare Payment Amount | 3314.13 |
| Total Medicare Standardized Payment Amount | 4874.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 78 |
| Number Of Medicare Beneficiaries With Drug Services | 76 |
| Total Drug Submitted ChargeAmount | 2895.31 |
| Total Drug Medicare AllowedAmount | 2582.69 |
| Total Drug Medicare PaymentAmount | 1603.98 |
| Total Drug Medicare Standardized Payment Amount | 1603.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 114 |
| Number Of Medicare Beneficiaries With Medical Services | 94 |
| Total Medical Submitted Charge Amount | 3862.99 |
| Total Medical Medicare Allowed Amount | 2834.97 |
| Total Medical Medicare Payment Amount | 1710.15 |
| Total Medical Medicare Standardized Payment Amount | 3270.79 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 57 |
| Number Of Beneficiaries Age 75 to 84 | 23 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 58 |
| 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 | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 20 |
| Percent Of With Hypertension | 31 |
| Percent Of With Ischemic Heart Disease | 11 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 15 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.7511 |