| National Provider Identifier [NPI]: | 1891887949 |
| Last Name Of The Provider | VILLALBA |
| First Name Of The Provider | MARCELO |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 208 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUBURNDALE |
| Zip Code Of The Provider | 338233404 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 3102 |
| Number Of Medicare Beneficiaries | 1788 |
| Total Submitted Charge Amount | 195902.46 |
| Total Medicare Allowed Amount | 169734.27 |
| Total Medicare Payment Amount | 127488.74 |
| Total Medicare Standardized Payment Amount | 129095.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 120 |
| Total Drug Medicare AllowedAmount | 3.03 |
| Total Drug Medicare PaymentAmount | 2.3 |
| Total Drug Medicare Standardized Payment Amount | 2.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 3078 |
| Number Of Medicare Beneficiaries With Medical Services | 1788 |
| Total Medical Submitted Charge Amount | 195782.46 |
| Total Medical Medicare Allowed Amount | 169731.24 |
| Total Medical Medicare Payment Amount | 127486.44 |
| Total Medical Medicare Standardized Payment Amount | 129093.29 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 335 |
| Number Of Beneficiaries Age 75 to 84 | 569 |
| Number Of Beneficiaries Age Greater 84 | 760 |
| Number Of Female Beneficiaries | 1188 |
| Number Of Male Beneficiaries | 600 |
| Number Of Non Hispanic White Beneficiaries | 1494 |
| Number Of Black or African American Beneficiaries | 183 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 88 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 679 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1109 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 65 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 56 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.3421 |