| National Provider Identifier [NPI]: | 1992714810 |
| Last Name Of The Provider | SORENSON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3200 WESTHILL DR |
| Street Address 2 Of The Provider | SUITE 210 |
| City Of The Provider | WAUSAU |
| Zip Code Of The Provider | 544014705 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 207 |
| Number Of Services | 2752 |
| Number Of Medicare Beneficiaries | 1681 |
| Total Submitted Charge Amount | 864087.25 |
| Total Medicare Allowed Amount | 105632.7 |
| Total Medicare Payment Amount | 80060.33 |
| Total Medicare Standardized Payment Amount | 83783.26 |
| 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 | 207 |
| Number Of Medical Services | 2752 |
| Number Of Medicare Beneficiaries With Medical Services | 1681 |
| Total Medical Submitted Charge Amount | 864087.25 |
| Total Medical Medicare Allowed Amount | 105632.7 |
| Total Medical Medicare Payment Amount | 80060.33 |
| Total Medical Medicare Standardized Payment Amount | 83783.26 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 316 |
| Number Of Beneficiaries Age 65 to 74 | 604 |
| Number Of Beneficiaries Age 75 to 84 | 482 |
| Number Of Beneficiaries Age Greater 84 | 279 |
| Number Of Female Beneficiaries | 905 |
| Number Of Male Beneficiaries | 776 |
| Number Of Non Hispanic White Beneficiaries | 1594 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 28 |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1191 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 490 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.7549 |