| National Provider Identifier [NPI]: | 1962483727 |
| Last Name Of The Provider | DESANTIS |
| First Name Of The Provider | DONNA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1455 W CHANDLER BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHANDLER |
| Zip Code Of The Provider | 852246197 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 992 |
| Number Of Medicare Beneficiaries | 206 |
| Total Submitted Charge Amount | 74375.97 |
| Total Medicare Allowed Amount | 70876.09 |
| Total Medicare Payment Amount | 52473.61 |
| Total Medicare Standardized Payment Amount | 54386.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 156 |
| Number Of Medicare Beneficiaries With Drug Services | 110 |
| Total Drug Submitted ChargeAmount | 6776 |
| Total Drug Medicare AllowedAmount | 5167.24 |
| Total Drug Medicare PaymentAmount | 5051.13 |
| Total Drug Medicare Standardized Payment Amount | 5051.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 836 |
| Number Of Medicare Beneficiaries With Medical Services | 206 |
| Total Medical Submitted Charge Amount | 67599.97 |
| Total Medical Medicare Allowed Amount | 65708.85 |
| Total Medical Medicare Payment Amount | 47422.48 |
| Total Medical Medicare Standardized Payment Amount | 49335.54 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 142 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 174 |
| Number Of Male Beneficiaries | 32 |
| Number Of Non Hispanic White Beneficiaries | 176 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 193 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7445 |