| National Provider Identifier [NPI]: | 1124118005 |
| Last Name Of The Provider | SANDNESS |
| First Name Of The Provider | KATHLEEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1015 S MOUNT CARMEL PL |
| Street Address 2 Of The Provider | |
| City Of The Provider | PITTSBURG |
| Zip Code Of The Provider | 667626604 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 4156 |
| Number Of Medicare Beneficiaries | 770 |
| Total Submitted Charge Amount | 401001.7 |
| Total Medicare Allowed Amount | 241852.29 |
| Total Medicare Payment Amount | 165699.34 |
| Total Medicare Standardized Payment Amount | 176952.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 454 |
| Number Of Medicare Beneficiaries With Drug Services | 191 |
| Total Drug Submitted ChargeAmount | 6830 |
| Total Drug Medicare AllowedAmount | 3425.05 |
| Total Drug Medicare PaymentAmount | 3165.45 |
| Total Drug Medicare Standardized Payment Amount | 3165.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 3702 |
| Number Of Medicare Beneficiaries With Medical Services | 770 |
| Total Medical Submitted Charge Amount | 394171.7 |
| Total Medical Medicare Allowed Amount | 238427.24 |
| Total Medical Medicare Payment Amount | 162533.89 |
| Total Medical Medicare Standardized Payment Amount | 173787.19 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 314 |
| Number Of Beneficiaries Age 75 to 84 | 232 |
| Number Of Beneficiaries Age Greater 84 | 158 |
| Number Of Female Beneficiaries | 474 |
| Number Of Male Beneficiaries | 296 |
| Number Of Non Hispanic White Beneficiaries | 753 |
| 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 | 649 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 121 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2484 |