| National Provider Identifier [NPI]: | 1659389294 |
| Last Name Of The Provider | SANDOVAL |
| First Name Of The Provider | ARMANDO |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1413 N ELM ST |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | HENDERSON |
| Zip Code Of The Provider | 424202768 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 1214 |
| Number Of Medicare Beneficiaries | 278 |
| Total Submitted Charge Amount | 107772 |
| Total Medicare Allowed Amount | 86447.59 |
| Total Medicare Payment Amount | 54182.88 |
| Total Medicare Standardized Payment Amount | 61059.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 42 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 830 |
| Total Drug Medicare AllowedAmount | 582.82 |
| Total Drug Medicare PaymentAmount | 570.77 |
| Total Drug Medicare Standardized Payment Amount | 570.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 1172 |
| Number Of Medicare Beneficiaries With Medical Services | 278 |
| Total Medical Submitted Charge Amount | 106942 |
| Total Medical Medicare Allowed Amount | 85864.77 |
| Total Medical Medicare Payment Amount | 53612.11 |
| Total Medical Medicare Standardized Payment Amount | 60488.72 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 105 |
| Number Of Beneficiaries Age 75 to 84 | 71 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 164 |
| Number Of Male Beneficiaries | 114 |
| Number Of Non Hispanic White Beneficiaries | 230 |
| Number Of Black or African American Beneficiaries | |
| 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 | 177 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 101 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3774 |