| National Provider Identifier [NPI]: | 1932217262 |
| Last Name Of The Provider | GANCAYCO |
| First Name Of The Provider | THEODORE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1160 VARNUM ST NE |
| Street Address 2 Of The Provider | SUITE 011 |
| City Of The Provider | WASHINGTON |
| Zip Code Of The Provider | 20017 |
| State Code Of The Provider | DC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 6378 |
| Number Of Medicare Beneficiaries | 1514 |
| Total Submitted Charge Amount | 1259555.94 |
| Total Medicare Allowed Amount | 693742.69 |
| Total Medicare Payment Amount | 509517.16 |
| Total Medicare Standardized Payment Amount | 447492.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 232 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 23275 |
| Total Drug Medicare AllowedAmount | 15279.26 |
| Total Drug Medicare PaymentAmount | 11894.37 |
| Total Drug Medicare Standardized Payment Amount | 11894.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 6146 |
| Number Of Medicare Beneficiaries With Medical Services | 1514 |
| Total Medical Submitted Charge Amount | 1236280.94 |
| Total Medical Medicare Allowed Amount | 678463.43 |
| Total Medical Medicare Payment Amount | 497622.79 |
| Total Medical Medicare Standardized Payment Amount | 435598.49 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 239 |
| Number Of Beneficiaries Age 65 to 74 | 635 |
| Number Of Beneficiaries Age 75 to 84 | 457 |
| Number Of Beneficiaries Age Greater 84 | 183 |
| Number Of Female Beneficiaries | 973 |
| Number Of Male Beneficiaries | 541 |
| Number Of Non Hispanic White Beneficiaries | 107 |
| Number Of Black or African American Beneficiaries | 1296 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | 59 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 883 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 631 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| 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 | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5077 |