| National Provider Identifier [NPI]: | 1780764019 |
| Last Name Of The Provider | CANDOCIA |
| 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 | 1618 BARCLAY BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BUFFALO GROVE |
| Zip Code Of The Provider | 600894523 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 3080 |
| Number Of Medicare Beneficiaries | 410 |
| Total Submitted Charge Amount | 458471.13 |
| Total Medicare Allowed Amount | 217274.74 |
| Total Medicare Payment Amount | 158178.69 |
| Total Medicare Standardized Payment Amount | 149525.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 238 |
| Number Of Medicare Beneficiaries With Drug Services | 173 |
| Total Drug Submitted ChargeAmount | 9122.6 |
| Total Drug Medicare AllowedAmount | 4306.12 |
| Total Drug Medicare PaymentAmount | 4130.38 |
| Total Drug Medicare Standardized Payment Amount | 4130.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 2842 |
| Number Of Medicare Beneficiaries With Medical Services | 410 |
| Total Medical Submitted Charge Amount | 449348.53 |
| Total Medical Medicare Allowed Amount | 212968.62 |
| Total Medical Medicare Payment Amount | 154048.31 |
| Total Medical Medicare Standardized Payment Amount | 145395.02 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 175 |
| Number Of Beneficiaries Age 75 to 84 | 135 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 235 |
| Number Of Male Beneficiaries | 175 |
| Number Of Non Hispanic White Beneficiaries | 352 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 397 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1412 |