| National Provider Identifier [NPI]: | 1518018811 |
| Last Name Of The Provider | CANCHIS |
| First Name Of The Provider | P |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1526 ATWOOD AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | JOHNSTON |
| Zip Code Of The Provider | 029193289 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 3792 |
| Number Of Medicare Beneficiaries | 1029 |
| Total Submitted Charge Amount | 282205 |
| Total Medicare Allowed Amount | 191885.33 |
| Total Medicare Payment Amount | 134163.41 |
| Total Medicare Standardized Payment Amount | 130495.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 286 |
| Number Of Medicare Beneficiaries With Drug Services | 106 |
| Total Drug Submitted ChargeAmount | 4678 |
| Total Drug Medicare AllowedAmount | 675.81 |
| Total Drug Medicare PaymentAmount | 578.11 |
| Total Drug Medicare Standardized Payment Amount | 578.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 3506 |
| Number Of Medicare Beneficiaries With Medical Services | 1008 |
| Total Medical Submitted Charge Amount | 277527 |
| Total Medical Medicare Allowed Amount | 191209.52 |
| Total Medical Medicare Payment Amount | 133585.3 |
| Total Medical Medicare Standardized Payment Amount | 129916.95 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 370 |
| Number Of Beneficiaries Age 65 to 74 | 327 |
| Number Of Beneficiaries Age 75 to 84 | 215 |
| Number Of Beneficiaries Age Greater 84 | 117 |
| Number Of Female Beneficiaries | 634 |
| Number Of Male Beneficiaries | 395 |
| Number Of Non Hispanic White Beneficiaries | 927 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 60 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 565 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 464 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.102 |