| National Provider Identifier [NPI]: | 1124008297 |
| Last Name Of The Provider | SANTOS |
| First Name Of The Provider | RAUL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 334 SMITH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | THOMASVILLE |
| Zip Code Of The Provider | 317925533 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 7218 |
| Number Of Medicare Beneficiaries | 810 |
| Total Submitted Charge Amount | 1400684 |
| Total Medicare Allowed Amount | 694026.16 |
| Total Medicare Payment Amount | 526936.93 |
| Total Medicare Standardized Payment Amount | 550741.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 652 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 24405 |
| Total Drug Medicare AllowedAmount | 6546.88 |
| Total Drug Medicare PaymentAmount | 4782.44 |
| Total Drug Medicare Standardized Payment Amount | 4782.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 6566 |
| Number Of Medicare Beneficiaries With Medical Services | 810 |
| Total Medical Submitted Charge Amount | 1376279 |
| Total Medical Medicare Allowed Amount | 687479.28 |
| Total Medical Medicare Payment Amount | 522154.49 |
| Total Medical Medicare Standardized Payment Amount | 545958.96 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 300 |
| Number Of Beneficiaries Age 65 to 74 | 252 |
| Number Of Beneficiaries Age 75 to 84 | 187 |
| Number Of Beneficiaries Age Greater 84 | 71 |
| Number Of Female Beneficiaries | 399 |
| Number Of Male Beneficiaries | 411 |
| Number Of Non Hispanic White Beneficiaries | 394 |
| Number Of Black or African American Beneficiaries | 400 |
| 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 | 428 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 382 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 63 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 4.4308 |