| National Provider Identifier [NPI]: | 1427005149 |
| Last Name Of The Provider | MARTINEZ-JIMENEZ |
| First Name Of The Provider | SANTIAGO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4101 N ROXBORO ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DURHAM |
| Zip Code Of The Provider | 277042121 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 6300 |
| Number Of Medicare Beneficiaries | 3672 |
| Total Submitted Charge Amount | 393293 |
| Total Medicare Allowed Amount | 111331.41 |
| Total Medicare Payment Amount | 84113.88 |
| Total Medicare Standardized Payment Amount | 84633.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 6300 |
| Number Of Medicare Beneficiaries With Medical Services | 3672 |
| Total Medical Submitted Charge Amount | 393293 |
| Total Medical Medicare Allowed Amount | 111331.41 |
| Total Medical Medicare Payment Amount | 84113.88 |
| Total Medical Medicare Standardized Payment Amount | 84633.63 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 764 |
| Number Of Beneficiaries Age 65 to 74 | 1110 |
| Number Of Beneficiaries Age 75 to 84 | 1042 |
| Number Of Beneficiaries Age Greater 84 | 756 |
| Number Of Female Beneficiaries | 1971 |
| Number Of Male Beneficiaries | 1701 |
| Number Of Non Hispanic White Beneficiaries | 3039 |
| Number Of Black or African American Beneficiaries | 511 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 73 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2882 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 790 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.1306 |