| National Provider Identifier [NPI]: | 1720035058 |
| Last Name Of The Provider | ALLEN |
| First Name Of The Provider | LUIS |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1685 LEE RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | WINTER PARK |
| Zip Code Of The Provider | 327892262 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 5239 |
| Number Of Medicare Beneficiaries | 1216 |
| Total Submitted Charge Amount | 929865.37 |
| Total Medicare Allowed Amount | 511698.32 |
| Total Medicare Payment Amount | 398321.59 |
| Total Medicare Standardized Payment Amount | 399820.3 |
| 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 | 13 |
| Number Of Medical Services | 5239 |
| Number Of Medicare Beneficiaries With Medical Services | 1216 |
| Total Medical Submitted Charge Amount | 929865.37 |
| Total Medical Medicare Allowed Amount | 511698.32 |
| Total Medical Medicare Payment Amount | 398321.59 |
| Total Medical Medicare Standardized Payment Amount | 399820.3 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 581 |
| Number Of Beneficiaries Age 65 to 74 | 304 |
| Number Of Beneficiaries Age 75 to 84 | 215 |
| Number Of Beneficiaries Age Greater 84 | 116 |
| Number Of Female Beneficiaries | 651 |
| Number Of Male Beneficiaries | 565 |
| Number Of Non Hispanic White Beneficiaries | 800 |
| Number Of Black or African American Beneficiaries | 185 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 194 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 541 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 675 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 40 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 52 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.1447 |