| National Provider Identifier [NPI]: | 1699971184 |
| Last Name Of The Provider | SANTOS |
| First Name Of The Provider | CAMILLE |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 16918 DOVE CANYON RD |
| Street Address 2 Of The Provider | SUITE #100 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921273501 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 224 |
| Number Of Medicare Beneficiaries | 62 |
| Total Submitted Charge Amount | 30312 |
| Total Medicare Allowed Amount | 17002.58 |
| Total Medicare Payment Amount | 11187.93 |
| Total Medicare Standardized Payment Amount | 10778.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 897 |
| Total Drug Medicare AllowedAmount | 848.68 |
| Total Drug Medicare PaymentAmount | 830.87 |
| Total Drug Medicare Standardized Payment Amount | 830.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 200 |
| Number Of Medicare Beneficiaries With Medical Services | 61 |
| Total Medical Submitted Charge Amount | 29415 |
| Total Medical Medicare Allowed Amount | 16153.9 |
| Total Medical Medicare Payment Amount | 10357.06 |
| Total Medical Medicare Standardized Payment Amount | 9947.61 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 38 |
| Number Of Beneficiaries Age 75 to 84 | 12 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 45 |
| Number Of Male Beneficiaries | 17 |
| Number Of Non Hispanic White Beneficiaries | 44 |
| 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 | 49 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 18 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.705 |