| National Provider Identifier [NPI]: | 1730328691 |
| Last Name Of The Provider | THEODOSATOS |
| First Name Of The Provider | ATHENA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO MPH |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 652 SAINT JOHNS CT |
| Street Address 2 Of The Provider | |
| City Of The Provider | WINTER PARK |
| Zip Code Of The Provider | 327924917 |
| 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 | 74 |
| Number Of Services | 3235 |
| Number Of Medicare Beneficiaries | 1142 |
| Total Submitted Charge Amount | 606342.96 |
| Total Medicare Allowed Amount | 355519.41 |
| Total Medicare Payment Amount | 276609.91 |
| Total Medicare Standardized Payment Amount | 279181.73 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 128 |
| Number Of Beneficiaries Age 65 to 74 | 227 |
| Number Of Beneficiaries Age 75 to 84 | 333 |
| Number Of Beneficiaries Age Greater 84 | 454 |
| Number Of Female Beneficiaries | 747 |
| Number Of Male Beneficiaries | 395 |
| Number Of Non Hispanic White Beneficiaries | 867 |
| Number Of Black or African American Beneficiaries | 93 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 158 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 396 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 746 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 70 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 59 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 23 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.2596 |