| National Provider Identifier [NPI]: | 1740398510 |
| Last Name Of The Provider | SANFORD |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2825 E BARNETT ROAD |
| Street Address 2 Of The Provider | ROGUE VALLEY MEDICAL CENTER |
| City Of The Provider | MEDFORD |
| Zip Code Of The Provider | 975040371 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 1266 |
| Number Of Medicare Beneficiaries | 478 |
| Total Submitted Charge Amount | 229270.22 |
| Total Medicare Allowed Amount | 120695.72 |
| Total Medicare Payment Amount | 91552.1 |
| Total Medicare Standardized Payment Amount | 94183.8 |
| 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 | 20 |
| Number Of Medical Services | 1266 |
| Number Of Medicare Beneficiaries With Medical Services | 478 |
| Total Medical Submitted Charge Amount | 229270.22 |
| Total Medical Medicare Allowed Amount | 120695.72 |
| Total Medical Medicare Payment Amount | 91552.1 |
| Total Medical Medicare Standardized Payment Amount | 94183.8 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | 155 |
| Number Of Beneficiaries Age 75 to 84 | 145 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 255 |
| Number Of Male Beneficiaries | 223 |
| Number Of Non Hispanic White Beneficiaries | 455 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 355 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 123 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8292 |