| National Provider Identifier [NPI]: | 1003996380 |
| Last Name Of The Provider | SAMBELL |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1626 W HIGHWAY 287 BUSINESS |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | WAXAHACHIE |
| Zip Code Of The Provider | 751654712 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 5117 |
| Number Of Medicare Beneficiaries | 1123 |
| Total Submitted Charge Amount | 922062 |
| Total Medicare Allowed Amount | 325429.93 |
| Total Medicare Payment Amount | 241172.94 |
| Total Medicare Standardized Payment Amount | 253231.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 513 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 192931 |
| Total Drug Medicare AllowedAmount | 49689.69 |
| Total Drug Medicare PaymentAmount | 38737.82 |
| Total Drug Medicare Standardized Payment Amount | 38737.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 4604 |
| Number Of Medicare Beneficiaries With Medical Services | 1123 |
| Total Medical Submitted Charge Amount | 729131 |
| Total Medical Medicare Allowed Amount | 275740.24 |
| Total Medical Medicare Payment Amount | 202435.12 |
| Total Medical Medicare Standardized Payment Amount | 214493.66 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 474 |
| Number Of Beneficiaries Age 75 to 84 | 418 |
| Number Of Beneficiaries Age Greater 84 | 156 |
| Number Of Female Beneficiaries | 279 |
| Number Of Male Beneficiaries | 844 |
| Number Of Non Hispanic White Beneficiaries | 1007 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 59 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1031 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1674 |