| National Provider Identifier [NPI]: | 1790760502 |
| Last Name Of The Provider | VIGO |
| First Name Of The Provider | GILBERTO |
| 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 | 1005 MAR WALT DR |
| Street Address 2 Of The Provider | INTERNAL MEDICINE DEPARTMENT |
| City Of The Provider | FORT WALTON BEACH |
| Zip Code Of The Provider | 325476707 |
| 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 | 10512 |
| Number Of Medicare Beneficiaries | 1083 |
| Total Submitted Charge Amount | 1067175 |
| Total Medicare Allowed Amount | 565958.85 |
| Total Medicare Payment Amount | 412392.41 |
| Total Medicare Standardized Payment Amount | 419617.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 5416 |
| Number Of Medicare Beneficiaries With Drug Services | 387 |
| Total Drug Submitted ChargeAmount | 142129 |
| Total Drug Medicare AllowedAmount | 79454.34 |
| Total Drug Medicare PaymentAmount | 65843.89 |
| Total Drug Medicare Standardized Payment Amount | 65843.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 5096 |
| Number Of Medicare Beneficiaries With Medical Services | 1083 |
| Total Medical Submitted Charge Amount | 925046 |
| Total Medical Medicare Allowed Amount | 486504.51 |
| Total Medical Medicare Payment Amount | 346548.52 |
| Total Medical Medicare Standardized Payment Amount | 353774.06 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 317 |
| Number Of Beneficiaries Age 75 to 84 | 428 |
| Number Of Beneficiaries Age Greater 84 | 256 |
| Number Of Female Beneficiaries | 619 |
| Number Of Male Beneficiaries | 464 |
| Number Of Non Hispanic White Beneficiaries | 970 |
| Number Of Black or African American Beneficiaries | 50 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 846 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 237 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6226 |