| National Provider Identifier [NPI]: | 1689652281 |
| Last Name Of The Provider | SANTOS |
| First Name Of The Provider | EDWIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 31 MAIN ST |
| Street Address 2 Of The Provider | CAMPTON MEDICAL ARTS, SUITE I |
| City Of The Provider | CAMPTON |
| Zip Code Of The Provider | 413019750 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 10826 |
| Number Of Medicare Beneficiaries | 783 |
| Total Submitted Charge Amount | 489978 |
| Total Medicare Allowed Amount | 372331.05 |
| Total Medicare Payment Amount | 266155.35 |
| Total Medicare Standardized Payment Amount | 289060.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 4582 |
| Number Of Medicare Beneficiaries With Drug Services | 428 |
| Total Drug Submitted ChargeAmount | 42048 |
| Total Drug Medicare AllowedAmount | 12088.44 |
| Total Drug Medicare PaymentAmount | 10828.16 |
| Total Drug Medicare Standardized Payment Amount | 10828.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 6244 |
| Number Of Medicare Beneficiaries With Medical Services | 783 |
| Total Medical Submitted Charge Amount | 447930 |
| Total Medical Medicare Allowed Amount | 360242.61 |
| Total Medical Medicare Payment Amount | 255327.19 |
| Total Medical Medicare Standardized Payment Amount | 278232.59 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 303 |
| Number Of Beneficiaries Age 65 to 74 | 239 |
| Number Of Beneficiaries Age 75 to 84 | 182 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 416 |
| Number Of Male Beneficiaries | 367 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 302 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 481 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1767 |