National Provider Identifier [NPI]: |
1134221195 |
Last Name Of The Provider |
SANTOS |
First Name Of The Provider |
CECILIA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5875 BREMO RD |
Street Address 2 Of The Provider |
SUITE 709 |
City Of The Provider |
RICHMOND |
Zip Code Of The Provider |
232261934 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
547 |
Number Of Medicare Beneficiaries |
263 |
Total Submitted Charge Amount |
376880 |
Total Medicare Allowed Amount |
107030.52 |
Total Medicare Payment Amount |
82221.89 |
Total Medicare Standardized Payment Amount |
84402.73 |
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 |
9 |
Number Of Medical Services |
547 |
Number Of Medicare Beneficiaries With Medical Services |
263 |
Total Medical Submitted Charge Amount |
376880 |
Total Medical Medicare Allowed Amount |
107030.52 |
Total Medical Medicare Payment Amount |
82221.89 |
Total Medical Medicare Standardized Payment Amount |
84402.73 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
161 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
128 |
Number Of Male Beneficiaries |
135 |
Number Of Non Hispanic White Beneficiaries |
184 |
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 |
235 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0971 |