| National Provider Identifier [NPI]: | 1750465514 |
| Last Name Of The Provider | SANCHIRICO |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 415 6TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEWISTON |
| Zip Code Of The Provider | 835012431 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 240 |
| Number Of Services | 6913 |
| Number Of Medicare Beneficiaries | 3286 |
| Total Submitted Charge Amount | 623732.55 |
| Total Medicare Allowed Amount | 229628.96 |
| Total Medicare Payment Amount | 175808.98 |
| Total Medicare Standardized Payment Amount | 187472.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 240 |
| Number Of Medical Services | 6913 |
| Number Of Medicare Beneficiaries With Medical Services | 3286 |
| Total Medical Submitted Charge Amount | 623732.55 |
| Total Medical Medicare Allowed Amount | 229628.96 |
| Total Medical Medicare Payment Amount | 175808.98 |
| Total Medical Medicare Standardized Payment Amount | 187472.03 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 609 |
| Number Of Beneficiaries Age 65 to 74 | 1254 |
| Number Of Beneficiaries Age 75 to 84 | 978 |
| Number Of Beneficiaries Age Greater 84 | 445 |
| Number Of Female Beneficiaries | 1942 |
| Number Of Male Beneficiaries | 1344 |
| Number Of Non Hispanic White Beneficiaries | 3116 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | 106 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2460 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 826 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2782 |