| National Provider Identifier [NPI]: | 1952339723 |
| Last Name Of The Provider | SANWICK |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 811 AINSWORTH DR |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | PRESCOTT |
| Zip Code Of The Provider | 863011687 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 4272 |
| Number Of Medicare Beneficiaries | 1007 |
| Total Submitted Charge Amount | 939722 |
| Total Medicare Allowed Amount | 349006.62 |
| Total Medicare Payment Amount | 264928.62 |
| Total Medicare Standardized Payment Amount | 266887.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 368 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 239253 |
| Total Drug Medicare AllowedAmount | 67700.09 |
| Total Drug Medicare PaymentAmount | 52757.57 |
| Total Drug Medicare Standardized Payment Amount | 52757.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 3904 |
| Number Of Medicare Beneficiaries With Medical Services | 1007 |
| Total Medical Submitted Charge Amount | 700469 |
| Total Medical Medicare Allowed Amount | 281306.53 |
| Total Medical Medicare Payment Amount | 212171.05 |
| Total Medical Medicare Standardized Payment Amount | 214129.64 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 446 |
| Number Of Beneficiaries Age 75 to 84 | 395 |
| Number Of Beneficiaries Age Greater 84 | 130 |
| Number Of Female Beneficiaries | 238 |
| Number Of Male Beneficiaries | 769 |
| Number Of Non Hispanic White Beneficiaries | 962 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 955 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1017 |