| National Provider Identifier [NPI]: | 1356450985 |
| Last Name Of The Provider | SANTOS |
| First Name Of The Provider | ROMAN |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 69 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAKEVILLE |
| Zip Code Of The Provider | 023473628 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 1495 |
| Number Of Medicare Beneficiaries | 322 |
| Total Submitted Charge Amount | 240741 |
| Total Medicare Allowed Amount | 147002.36 |
| Total Medicare Payment Amount | 108176.76 |
| Total Medicare Standardized Payment Amount | 105517.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 58 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 2635 |
| Total Drug Medicare AllowedAmount | 1069.93 |
| Total Drug Medicare PaymentAmount | 1035.51 |
| Total Drug Medicare Standardized Payment Amount | 1035.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 1437 |
| Number Of Medicare Beneficiaries With Medical Services | 322 |
| Total Medical Submitted Charge Amount | 238106 |
| Total Medical Medicare Allowed Amount | 145932.43 |
| Total Medical Medicare Payment Amount | 107141.25 |
| Total Medical Medicare Standardized Payment Amount | 104481.8 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 125 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 163 |
| Number Of Male Beneficiaries | 159 |
| Number Of Non Hispanic White Beneficiaries | 293 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 224 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 98 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0497 |