| National Provider Identifier [NPI]: | 1679596712 |
| Last Name Of The Provider | DESANTO |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10122 E 10TH ST |
| Street Address 2 Of The Provider | SUITE 220 |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462292664 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 2737 |
| Number Of Medicare Beneficiaries | 620 |
| Total Submitted Charge Amount | 290856 |
| Total Medicare Allowed Amount | 195532.03 |
| Total Medicare Payment Amount | 144373.38 |
| Total Medicare Standardized Payment Amount | 152675.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 233 |
| Number Of Medicare Beneficiaries With Drug Services | 188 |
| Total Drug Submitted ChargeAmount | 7089 |
| Total Drug Medicare AllowedAmount | 4734.37 |
| Total Drug Medicare PaymentAmount | 4596.16 |
| Total Drug Medicare Standardized Payment Amount | 4596.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 2504 |
| Number Of Medicare Beneficiaries With Medical Services | 620 |
| Total Medical Submitted Charge Amount | 283767 |
| Total Medical Medicare Allowed Amount | 190797.66 |
| Total Medical Medicare Payment Amount | 139777.22 |
| Total Medical Medicare Standardized Payment Amount | 148079.12 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 145 |
| Number Of Beneficiaries Age 75 to 84 | 173 |
| Number Of Beneficiaries Age Greater 84 | 241 |
| Number Of Female Beneficiaries | 382 |
| Number Of Male Beneficiaries | 238 |
| Number Of Non Hispanic White Beneficiaries | 592 |
| 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 | 552 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 68 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2887 |