| National Provider Identifier [NPI]: | 1982600417 |
| Last Name Of The Provider | TALLO |
| First Name Of The Provider | RAUL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 130 PABLO ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAKELAND |
| Zip Code Of The Provider | 338033818 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 135 |
| Number Of Services | 60250 |
| Number Of Medicare Beneficiaries | 1002 |
| Total Submitted Charge Amount | 2642414 |
| Total Medicare Allowed Amount | 1258121.94 |
| Total Medicare Payment Amount | 899160.34 |
| Total Medicare Standardized Payment Amount | 907038.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 52859 |
| Number Of Medicare Beneficiaries With Drug Services | 342 |
| Total Drug Submitted ChargeAmount | 2046275 |
| Total Drug Medicare AllowedAmount | 960221.56 |
| Total Drug Medicare PaymentAmount | 673432.55 |
| Total Drug Medicare Standardized Payment Amount | 673432.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 117 |
| Number Of Medical Services | 7391 |
| Number Of Medicare Beneficiaries With Medical Services | 1001 |
| Total Medical Submitted Charge Amount | 596139 |
| Total Medical Medicare Allowed Amount | 297900.38 |
| Total Medical Medicare Payment Amount | 225727.79 |
| Total Medical Medicare Standardized Payment Amount | 233605.51 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 131 |
| Number Of Beneficiaries Age 65 to 74 | 414 |
| Number Of Beneficiaries Age 75 to 84 | 338 |
| Number Of Beneficiaries Age Greater 84 | 119 |
| Number Of Female Beneficiaries | 808 |
| Number Of Male Beneficiaries | 194 |
| Number Of Non Hispanic White Beneficiaries | 827 |
| Number Of Black or African American Beneficiaries | 105 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 846 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 156 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 26 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 70 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4691 |