| National Provider Identifier [NPI]: | 1023299393 |
| Last Name Of The Provider | SANTOS |
| First Name Of The Provider | CARLOS |
| 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 | 10 BARNES WEST DR |
| Street Address 2 Of The Provider | POB 2 STE 200 |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631416350 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 552 |
| Number Of Medicare Beneficiaries | 229 |
| Total Submitted Charge Amount | 131613 |
| Total Medicare Allowed Amount | 53335.31 |
| Total Medicare Payment Amount | 40360.87 |
| Total Medicare Standardized Payment Amount | 41061.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 23 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 3877 |
| Total Drug Medicare AllowedAmount | 1983.74 |
| Total Drug Medicare PaymentAmount | 1944.04 |
| Total Drug Medicare Standardized Payment Amount | 1944.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 529 |
| Number Of Medicare Beneficiaries With Medical Services | 229 |
| Total Medical Submitted Charge Amount | 127736 |
| Total Medical Medicare Allowed Amount | 51351.57 |
| Total Medical Medicare Payment Amount | 38416.83 |
| Total Medical Medicare Standardized Payment Amount | 39117.58 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 114 |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 79 |
| Number Of Male Beneficiaries | 150 |
| Number Of Non Hispanic White Beneficiaries | 149 |
| Number Of Black or African American Beneficiaries | 68 |
| 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 | 144 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 65 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 3.2194 |