National Provider Identifier [NPI]: |
1063579290 |
Last Name Of The Provider |
SANTOS |
First Name Of The Provider |
RAYMUND |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
701 N CLAYTON ST |
Street Address 2 Of The Provider |
3RD FLOOR |
City Of The Provider |
WILMINGTON |
Zip Code Of The Provider |
198053518 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
525 |
Number Of Medicare Beneficiaries |
460 |
Total Submitted Charge Amount |
485090 |
Total Medicare Allowed Amount |
57041.97 |
Total Medicare Payment Amount |
44089.9 |
Total Medicare Standardized Payment Amount |
41648.51 |
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 |
74 |
Number Of Medical Services |
525 |
Number Of Medicare Beneficiaries With Medical Services |
460 |
Total Medical Submitted Charge Amount |
485090 |
Total Medical Medicare Allowed Amount |
57041.97 |
Total Medical Medicare Payment Amount |
44089.9 |
Total Medical Medicare Standardized Payment Amount |
41648.51 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
244 |
Number Of Beneficiaries Age 75 to 84 |
118 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
241 |
Number Of Male Beneficiaries |
219 |
Number Of Non Hispanic White Beneficiaries |
414 |
Number Of Black or African American Beneficiaries |
31 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
412 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3634 |