| National Provider Identifier [NPI]: | 1437122165 |
| Last Name Of The Provider | ACOSTA-FAJARDO |
| First Name Of The Provider | ALESSANDRO |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1317 W POINT DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | COCOA |
| Zip Code Of The Provider | 329226464 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 1690 |
| Number Of Medicare Beneficiaries | 243 |
| Total Submitted Charge Amount | 232086 |
| Total Medicare Allowed Amount | 93501.15 |
| Total Medicare Payment Amount | 64070.68 |
| Total Medicare Standardized Payment Amount | 65088.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 121 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 3024 |
| Total Drug Medicare AllowedAmount | 1512.87 |
| Total Drug Medicare PaymentAmount | 1269.03 |
| Total Drug Medicare Standardized Payment Amount | 1269.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 1569 |
| Number Of Medicare Beneficiaries With Medical Services | 243 |
| Total Medical Submitted Charge Amount | 229062 |
| Total Medical Medicare Allowed Amount | 91988.28 |
| Total Medical Medicare Payment Amount | 62801.65 |
| Total Medical Medicare Standardized Payment Amount | 63819.26 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 107 |
| Number Of Beneficiaries Age 75 to 84 | 86 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 132 |
| Number Of Male Beneficiaries | 111 |
| Number Of Non Hispanic White Beneficiaries | 192 |
| Number Of Black or African American Beneficiaries | 31 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 201 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1073 |