National Provider Identifier [NPI]: |
1396748331 |
Last Name Of The Provider |
SORENSEN |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6286 BRIARCREST AVE |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381204023 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
2685 |
Number Of Medicare Beneficiaries |
564 |
Total Submitted Charge Amount |
849577 |
Total Medicare Allowed Amount |
199235.35 |
Total Medicare Payment Amount |
144717.24 |
Total Medicare Standardized Payment Amount |
153555.79 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
125 |
Number Of Medicare Beneficiaries With Drug Services |
65 |
Total Drug Submitted ChargeAmount |
1266 |
Total Drug Medicare AllowedAmount |
544.37 |
Total Drug Medicare PaymentAmount |
413.18 |
Total Drug Medicare Standardized Payment Amount |
413.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
57 |
Number Of Medical Services |
2560 |
Number Of Medicare Beneficiaries With Medical Services |
564 |
Total Medical Submitted Charge Amount |
848311 |
Total Medical Medicare Allowed Amount |
198690.98 |
Total Medical Medicare Payment Amount |
144304.06 |
Total Medical Medicare Standardized Payment Amount |
153142.61 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
264 |
Number Of Beneficiaries Age 75 to 84 |
182 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
373 |
Number Of Male Beneficiaries |
191 |
Number Of Non Hispanic White Beneficiaries |
481 |
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 |
517 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.0105 |