| National Provider Identifier [NPI]: | 1124227871 |
| Last Name Of The Provider | SANTIAGO |
| First Name Of The Provider | YESENIA |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4700 SHERIDAN ST |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | HOLLYWOOD |
| Zip Code Of The Provider | 330213420 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 21581 |
| Number Of Medicare Beneficiaries | 424 |
| Total Submitted Charge Amount | 603305 |
| Total Medicare Allowed Amount | 350107.38 |
| Total Medicare Payment Amount | 269580.96 |
| Total Medicare Standardized Payment Amount | 265570.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 19412 |
| Number Of Medicare Beneficiaries With Drug Services | 201 |
| Total Drug Submitted ChargeAmount | 399275 |
| Total Drug Medicare AllowedAmount | 213992.74 |
| Total Drug Medicare PaymentAmount | 167686.54 |
| Total Drug Medicare Standardized Payment Amount | 167686.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 2169 |
| Number Of Medicare Beneficiaries With Medical Services | 424 |
| Total Medical Submitted Charge Amount | 204030 |
| Total Medical Medicare Allowed Amount | 136114.64 |
| Total Medical Medicare Payment Amount | 101894.42 |
| Total Medical Medicare Standardized Payment Amount | 97884.21 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 88 |
| Number Of Beneficiaries Age 65 to 74 | 154 |
| Number Of Beneficiaries Age 75 to 84 | 129 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 335 |
| Number Of Male Beneficiaries | 89 |
| Number Of Non Hispanic White Beneficiaries | 285 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 67 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 306 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 118 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 33 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5074 |