| National Provider Identifier [NPI]: | 1235187808 |
| Last Name Of The Provider | SANTUCCI |
| First Name Of The Provider | GAIL |
| 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 | 8791 CONFERENCE DR |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339195822 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 233 |
| Number Of Services | 12441.5 |
| Number Of Medicare Beneficiaries | 4426 |
| Total Submitted Charge Amount | 809570.81 |
| Total Medicare Allowed Amount | 313041.71 |
| Total Medicare Payment Amount | 247169.99 |
| Total Medicare Standardized Payment Amount | 239689.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 5835.5 |
| Number Of Medicare Beneficiaries With Drug Services | 72 |
| Total Drug Submitted ChargeAmount | 19555.72 |
| Total Drug Medicare AllowedAmount | 1877.84 |
| Total Drug Medicare PaymentAmount | 1423.91 |
| Total Drug Medicare Standardized Payment Amount | 1423.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 228 |
| Number Of Medical Services | 6606 |
| Number Of Medicare Beneficiaries With Medical Services | 4423 |
| Total Medical Submitted Charge Amount | 790015.09 |
| Total Medical Medicare Allowed Amount | 311163.87 |
| Total Medical Medicare Payment Amount | 245746.08 |
| Total Medical Medicare Standardized Payment Amount | 238265.53 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 461 |
| Number Of Beneficiaries Age 65 to 74 | 1726 |
| Number Of Beneficiaries Age 75 to 84 | 1455 |
| Number Of Beneficiaries Age Greater 84 | 784 |
| Number Of Female Beneficiaries | 2913 |
| Number Of Male Beneficiaries | 1513 |
| Number Of Non Hispanic White Beneficiaries | 3984 |
| Number Of Black or African American Beneficiaries | 147 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 198 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 54 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3799 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 627 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4278 |