| National Provider Identifier [NPI]: | 1790768463 |
| Last Name Of The Provider | CONSTANTE |
| First Name Of The Provider | GALO |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12400 BRANTLEY COMMONS CT |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339075663 |
| 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 | 39 |
| Number Of Services | 1280 |
| Number Of Medicare Beneficiaries | 149 |
| Total Submitted Charge Amount | 110319 |
| Total Medicare Allowed Amount | 85635.72 |
| Total Medicare Payment Amount | 64550.42 |
| Total Medicare Standardized Payment Amount | 61970.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 111 |
| Number Of Medicare Beneficiaries With Drug Services | 71 |
| Total Drug Submitted ChargeAmount | 6235 |
| Total Drug Medicare AllowedAmount | 4191.83 |
| Total Drug Medicare PaymentAmount | 4104.91 |
| Total Drug Medicare Standardized Payment Amount | 4104.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 1169 |
| Number Of Medicare Beneficiaries With Medical Services | 149 |
| Total Medical Submitted Charge Amount | 104084 |
| Total Medical Medicare Allowed Amount | 81443.89 |
| Total Medical Medicare Payment Amount | 60445.51 |
| Total Medical Medicare Standardized Payment Amount | 57865.97 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 75 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 80 |
| Number Of Male Beneficiaries | 69 |
| Number Of Non Hispanic White Beneficiaries | 94 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 121 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0627 |