| National Provider Identifier [NPI]: | 1043257074 |
| Last Name Of The Provider | SANNER |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 815 E ROYALL BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MALAKOFF |
| Zip Code Of The Provider | 751489255 |
| 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 | 41 |
| Number Of Services | 3253 |
| Number Of Medicare Beneficiaries | 411 |
| Total Submitted Charge Amount | 297760.23 |
| Total Medicare Allowed Amount | 206250.02 |
| Total Medicare Payment Amount | 146966.95 |
| Total Medicare Standardized Payment Amount | 143865.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 117 |
| Number Of Medicare Beneficiaries With Drug Services | 114 |
| Total Drug Submitted ChargeAmount | 2925 |
| Total Drug Medicare AllowedAmount | 1641.46 |
| Total Drug Medicare PaymentAmount | 1608.86 |
| Total Drug Medicare Standardized Payment Amount | 1608.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 3136 |
| Number Of Medicare Beneficiaries With Medical Services | 411 |
| Total Medical Submitted Charge Amount | 294835.23 |
| Total Medical Medicare Allowed Amount | 204608.56 |
| Total Medical Medicare Payment Amount | 145358.09 |
| Total Medical Medicare Standardized Payment Amount | 142256.69 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 112 |
| Number Of Beneficiaries Age 65 to 74 | 126 |
| Number Of Beneficiaries Age 75 to 84 | 105 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 218 |
| Number Of Male Beneficiaries | 193 |
| Number Of Non Hispanic White Beneficiaries | 360 |
| Number Of Black or African American Beneficiaries | 35 |
| 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 | 249 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 162 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4716 |