| National Provider Identifier [NPI]: | 1629042304 |
| Last Name Of The Provider | SANFORD |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 107 BRANDON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | STARKVILLE |
| Zip Code Of The Provider | 397592521 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 162 |
| Number Of Services | 32040 |
| Number Of Medicare Beneficiaries | 1127 |
| Total Submitted Charge Amount | 1691907 |
| Total Medicare Allowed Amount | 813623.49 |
| Total Medicare Payment Amount | 622487.95 |
| Total Medicare Standardized Payment Amount | 662392.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 30 |
| Number Of Drug Services | 6261 |
| Number Of Medicare Beneficiaries With Drug Services | 625 |
| Total Drug Submitted ChargeAmount | 294424 |
| Total Drug Medicare AllowedAmount | 131144.11 |
| Total Drug Medicare PaymentAmount | 102611.71 |
| Total Drug Medicare Standardized Payment Amount | 102611.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 132 |
| Number Of Medical Services | 25779 |
| Number Of Medicare Beneficiaries With Medical Services | 1127 |
| Total Medical Submitted Charge Amount | 1397483 |
| Total Medical Medicare Allowed Amount | 682479.38 |
| Total Medical Medicare Payment Amount | 519876.24 |
| Total Medical Medicare Standardized Payment Amount | 559780.77 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 178 |
| Number Of Beneficiaries Age 65 to 74 | 425 |
| Number Of Beneficiaries Age 75 to 84 | 359 |
| Number Of Beneficiaries Age Greater 84 | 165 |
| Number Of Female Beneficiaries | 639 |
| Number Of Male Beneficiaries | 488 |
| Number Of Non Hispanic White Beneficiaries | 825 |
| 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 | 849 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 278 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0867 |