| National Provider Identifier [NPI]: | 1275587388 |
| Last Name Of The Provider | SONN |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 63 BARKLEY CIR |
| Street Address 2 Of The Provider | STE. 100 & 101 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339074514 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 274 |
| Number Of Services | 10078 |
| Number Of Medicare Beneficiaries | 5046 |
| Total Submitted Charge Amount | 934428 |
| Total Medicare Allowed Amount | 320163.67 |
| Total Medicare Payment Amount | 249012.41 |
| Total Medicare Standardized Payment Amount | 238241.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2201 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 7214 |
| Total Drug Medicare AllowedAmount | 577.52 |
| Total Drug Medicare PaymentAmount | 452.74 |
| Total Drug Medicare Standardized Payment Amount | 452.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 271 |
| Number Of Medical Services | 7877 |
| Number Of Medicare Beneficiaries With Medical Services | 5045 |
| Total Medical Submitted Charge Amount | 927214 |
| Total Medical Medicare Allowed Amount | 319586.15 |
| Total Medical Medicare Payment Amount | 248559.67 |
| Total Medical Medicare Standardized Payment Amount | 237789.1 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 626 |
| Number Of Beneficiaries Age 65 to 74 | 1757 |
| Number Of Beneficiaries Age 75 to 84 | 1646 |
| Number Of Beneficiaries Age Greater 84 | 1017 |
| Number Of Female Beneficiaries | 2717 |
| Number Of Male Beneficiaries | 2329 |
| Number Of Non Hispanic White Beneficiaries | 4453 |
| Number Of Black or African American Beneficiaries | 215 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 298 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4024 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1022 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6955 |