| National Provider Identifier [NPI]: | 1346200987 |
| Last Name Of The Provider | SANDER |
| First Name Of The Provider | RICKIE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1200 RIVERPLACE BLVD |
| Street Address 2 Of The Provider | SUITE 620 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322079046 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 6621 |
| Number Of Medicare Beneficiaries | 773 |
| Total Submitted Charge Amount | 923059 |
| Total Medicare Allowed Amount | 567495.77 |
| Total Medicare Payment Amount | 429174.57 |
| Total Medicare Standardized Payment Amount | 430054.7 |
| 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 | 24 |
| Number Of Medical Services | 6621 |
| Number Of Medicare Beneficiaries With Medical Services | 773 |
| Total Medical Submitted Charge Amount | 923059 |
| Total Medical Medicare Allowed Amount | 567495.77 |
| Total Medical Medicare Payment Amount | 429174.57 |
| Total Medical Medicare Standardized Payment Amount | 430054.7 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 122 |
| Number Of Beneficiaries Age 65 to 74 | 200 |
| Number Of Beneficiaries Age 75 to 84 | 230 |
| Number Of Beneficiaries Age Greater 84 | 221 |
| Number Of Female Beneficiaries | 513 |
| Number Of Male Beneficiaries | 260 |
| Number Of Non Hispanic White Beneficiaries | 483 |
| Number Of Black or African American Beneficiaries | 268 |
| 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 | 329 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 444 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 56 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 56 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 73 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 21 |
| Percent Of With Stroke | 27 |
| Average HCC Risk Score Of Beneficiaries | 2.5892 |