| National Provider Identifier [NPI]: | 1821185893 |
| Last Name Of The Provider | TOBILLO |
| First Name Of The Provider | EMLYN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MSN, ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3303 S SEMORAN BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORLANDO |
| Zip Code Of The Provider | 328222500 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 2126 |
| Number Of Medicare Beneficiaries | 265 |
| Total Submitted Charge Amount | 204774.65 |
| Total Medicare Allowed Amount | 141232.37 |
| Total Medicare Payment Amount | 105776.22 |
| Total Medicare Standardized Payment Amount | 120906.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1126 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 32373.55 |
| Total Drug Medicare AllowedAmount | 29826.22 |
| Total Drug Medicare PaymentAmount | 23642.15 |
| Total Drug Medicare Standardized Payment Amount | 23642.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 1000 |
| Number Of Medicare Beneficiaries With Medical Services | 264 |
| Total Medical Submitted Charge Amount | 172401.1 |
| Total Medical Medicare Allowed Amount | 111406.15 |
| Total Medical Medicare Payment Amount | 82134.07 |
| Total Medical Medicare Standardized Payment Amount | 97264.12 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 65 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 159 |
| Number Of Male Beneficiaries | 106 |
| Number Of Non Hispanic White Beneficiaries | 186 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 141 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 124 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 48 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 57 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 40 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5299 |