| National Provider Identifier [NPI]: | 1871672436 |
| Last Name Of The Provider | SANDERCOCK |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3338 OAKWELL COURT |
| Street Address 2 Of The Provider | SUITE 107 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782183019 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 1138 |
| Number Of Medicare Beneficiaries | 338 |
| Total Submitted Charge Amount | 135881 |
| Total Medicare Allowed Amount | 73705.74 |
| Total Medicare Payment Amount | 51053.65 |
| Total Medicare Standardized Payment Amount | 54528.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 163 |
| Number Of Medicare Beneficiaries With Drug Services | 86 |
| Total Drug Submitted ChargeAmount | 5683 |
| Total Drug Medicare AllowedAmount | 3507 |
| Total Drug Medicare PaymentAmount | 3313.91 |
| Total Drug Medicare Standardized Payment Amount | 3313.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 975 |
| Number Of Medicare Beneficiaries With Medical Services | 338 |
| Total Medical Submitted Charge Amount | 130198 |
| Total Medical Medicare Allowed Amount | 70198.74 |
| Total Medical Medicare Payment Amount | 47739.74 |
| Total Medical Medicare Standardized Payment Amount | 51214.58 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 181 |
| Number Of Beneficiaries Age 75 to 84 | 86 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 187 |
| Number Of Male Beneficiaries | 151 |
| Number Of Non Hispanic White Beneficiaries | 271 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 315 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8897 |