| National Provider Identifier [NPI]: | 1457318636 |
| Last Name Of The Provider | ULLOA |
| First Name Of The Provider | LUIS |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 601 UNIVERSITY BLVD |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | JUPITER |
| Zip Code Of The Provider | 334582788 |
| 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 | 57 |
| Number Of Services | 2831 |
| Number Of Medicare Beneficiaries | 406 |
| Total Submitted Charge Amount | 624855.62 |
| Total Medicare Allowed Amount | 218933.06 |
| Total Medicare Payment Amount | 172158.48 |
| Total Medicare Standardized Payment Amount | 165035.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 112 |
| Number Of Medicare Beneficiaries With Drug Services | 92 |
| Total Drug Submitted ChargeAmount | 3360 |
| Total Drug Medicare AllowedAmount | 1572.69 |
| Total Drug Medicare PaymentAmount | 1532.18 |
| Total Drug Medicare Standardized Payment Amount | 1532.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 2719 |
| Number Of Medicare Beneficiaries With Medical Services | 406 |
| Total Medical Submitted Charge Amount | 621495.62 |
| Total Medical Medicare Allowed Amount | 217360.37 |
| Total Medical Medicare Payment Amount | 170626.3 |
| Total Medical Medicare Standardized Payment Amount | 163503.22 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 162 |
| Number Of Beneficiaries Age 75 to 84 | 142 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 205 |
| Number Of Male Beneficiaries | 201 |
| Number Of Non Hispanic White Beneficiaries | 356 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 381 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.238 |