| National Provider Identifier [NPI]: | 1528006533 |
| Last Name Of The Provider | SURI |
| First Name Of The Provider | SONU |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 MERCY WAY |
| Street Address 2 Of The Provider | DEPT OF RADIOLOGY |
| City Of The Provider | JOPLIN |
| Zip Code Of The Provider | 648044524 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 163 |
| Number Of Services | 6617 |
| Number Of Medicare Beneficiaries | 3671 |
| Total Submitted Charge Amount | 467211 |
| Total Medicare Allowed Amount | 161145.42 |
| Total Medicare Payment Amount | 125792.87 |
| Total Medicare Standardized Payment Amount | 132708.11 |
| 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 | 163 |
| Number Of Medical Services | 6617 |
| Number Of Medicare Beneficiaries With Medical Services | 3671 |
| Total Medical Submitted Charge Amount | 467211 |
| Total Medical Medicare Allowed Amount | 161145.42 |
| Total Medical Medicare Payment Amount | 125792.87 |
| Total Medical Medicare Standardized Payment Amount | 132708.11 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 825 |
| Number Of Beneficiaries Age 65 to 74 | 1325 |
| Number Of Beneficiaries Age 75 to 84 | 1044 |
| Number Of Beneficiaries Age Greater 84 | 477 |
| Number Of Female Beneficiaries | 2360 |
| Number Of Male Beneficiaries | 1311 |
| Number Of Non Hispanic White Beneficiaries | 3504 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | 67 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2646 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1025 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6045 |