| National Provider Identifier [NPI]: | 1861650202 |
| Last Name Of The Provider | GALLEGO |
| First Name Of The Provider | ESTEBAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2950 CLEVELAND CLINIC BLVD |
| Street Address 2 Of The Provider | DEPT OF INTERNAL MEDICINE |
| City Of The Provider | WESTON |
| Zip Code Of The Provider | 333313609 |
| 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 | 45 |
| Number Of Services | 1399 |
| Number Of Medicare Beneficiaries | 485 |
| Total Submitted Charge Amount | 274497.49 |
| Total Medicare Allowed Amount | 103524.11 |
| Total Medicare Payment Amount | 77593.4 |
| Total Medicare Standardized Payment Amount | 75029.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 309 |
| Number Of Medicare Beneficiaries With Drug Services | 92 |
| Total Drug Submitted ChargeAmount | 16101.65 |
| Total Drug Medicare AllowedAmount | 5763.84 |
| Total Drug Medicare PaymentAmount | 5044.25 |
| Total Drug Medicare Standardized Payment Amount | 5044.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 1090 |
| Number Of Medicare Beneficiaries With Medical Services | 484 |
| Total Medical Submitted Charge Amount | 258395.84 |
| Total Medical Medicare Allowed Amount | 97760.27 |
| Total Medical Medicare Payment Amount | 72549.15 |
| Total Medical Medicare Standardized Payment Amount | 69985.71 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 193 |
| Number Of Beneficiaries Age 75 to 84 | 164 |
| Number Of Beneficiaries Age Greater 84 | 76 |
| Number Of Female Beneficiaries | 226 |
| Number Of Male Beneficiaries | 259 |
| Number Of Non Hispanic White Beneficiaries | 310 |
| Number Of Black or African American Beneficiaries | 54 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 104 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 402 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6467 |