| National Provider Identifier [NPI]: | 1760454458 |
| Last Name Of The Provider | SANTIAGO |
| First Name Of The Provider | MANUEL |
| 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 | 4411 MEDICAL DR |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782293822 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 172 |
| Number Of Services | 110388 |
| Number Of Medicare Beneficiaries | 644 |
| Total Submitted Charge Amount | 6073779 |
| Total Medicare Allowed Amount | 1829124.4 |
| Total Medicare Payment Amount | 1387395.88 |
| Total Medicare Standardized Payment Amount | 1405598.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 69 |
| Number Of Drug Services | 101072 |
| Number Of Medicare Beneficiaries With Drug Services | 168 |
| Total Drug Submitted ChargeAmount | 4909689 |
| Total Drug Medicare AllowedAmount | 1467280.08 |
| Total Drug Medicare PaymentAmount | 1111384.09 |
| Total Drug Medicare Standardized Payment Amount | 1111384.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 103 |
| Number Of Medical Services | 9316 |
| Number Of Medicare Beneficiaries With Medical Services | 643 |
| Total Medical Submitted Charge Amount | 1164090 |
| Total Medical Medicare Allowed Amount | 361844.32 |
| Total Medical Medicare Payment Amount | 276011.79 |
| Total Medical Medicare Standardized Payment Amount | 294214.04 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 109 |
| Number Of Beneficiaries Age 65 to 74 | 234 |
| Number Of Beneficiaries Age 75 to 84 | 219 |
| Number Of Beneficiaries Age Greater 84 | 82 |
| Number Of Female Beneficiaries | 368 |
| Number Of Male Beneficiaries | 276 |
| Number Of Non Hispanic White Beneficiaries | 287 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 324 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 467 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 177 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.1654 |