| National Provider Identifier [NPI]: | 1780622449 |
| Last Name Of The Provider | GALLO |
| First Name Of The Provider | ANTHONY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 593 EDDY ST |
| Street Address 2 Of The Provider | APC 9 |
| City Of The Provider | PROVIDENCE |
| Zip Code Of The Provider | 029034923 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 1758 |
| Number Of Medicare Beneficiaries | 355 |
| Total Submitted Charge Amount | 332289 |
| Total Medicare Allowed Amount | 204543.01 |
| Total Medicare Payment Amount | 157383.51 |
| Total Medicare Standardized Payment Amount | 153615.36 |
| 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 | 1758 |
| Number Of Medicare Beneficiaries With Medical Services | 355 |
| Total Medical Submitted Charge Amount | 332289 |
| Total Medical Medicare Allowed Amount | 204543.01 |
| Total Medical Medicare Payment Amount | 157383.51 |
| Total Medical Medicare Standardized Payment Amount | 153615.36 |
| Average Age Of Beneficiaries | 56 |
| Number Of Beneficiaries Age Less65 | 243 |
| Number Of Beneficiaries Age 65 to 74 | 68 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 187 |
| Number Of Male Beneficiaries | 168 |
| Number Of Non Hispanic White Beneficiaries | 263 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 91 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 264 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 60 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.551 |