| National Provider Identifier [NPI]: | 1710099585 |
| Last Name Of The Provider | CENTURION |
| First Name Of The Provider | SANTIAGO |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 106 LYNCH CREEK WAY |
| Street Address 2 Of The Provider | SUITE 8 |
| City Of The Provider | PETALUMA |
| Zip Code Of The Provider | 949542356 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 13321 |
| Number Of Medicare Beneficiaries | 1506 |
| Total Submitted Charge Amount | 4096994 |
| Total Medicare Allowed Amount | 2452818.29 |
| Total Medicare Payment Amount | 1874576.29 |
| Total Medicare Standardized Payment Amount | 1496544.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 33 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 830 |
| Total Drug Medicare AllowedAmount | 58.98 |
| Total Drug Medicare PaymentAmount | 39.12 |
| Total Drug Medicare Standardized Payment Amount | 39.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 13288 |
| Number Of Medicare Beneficiaries With Medical Services | 1506 |
| Total Medical Submitted Charge Amount | 4096164 |
| Total Medical Medicare Allowed Amount | 2452759.31 |
| Total Medical Medicare Payment Amount | 1874537.17 |
| Total Medical Medicare Standardized Payment Amount | 1496504.96 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 744 |
| Number Of Beneficiaries Age 75 to 84 | 450 |
| Number Of Beneficiaries Age Greater 84 | 243 |
| Number Of Female Beneficiaries | 711 |
| Number Of Male Beneficiaries | 795 |
| Number Of Non Hispanic White Beneficiaries | 1410 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1448 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0087 |