| National Provider Identifier [NPI]: | 1194717595 |
| Last Name Of The Provider | LAGOUTARIS |
| First Name Of The Provider | EFSTRATIOS |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1361 13TH AVE S |
| Street Address 2 Of The Provider | STE 12 |
| City Of The Provider | JACKSONVILLE BEACH |
| Zip Code Of The Provider | 32250 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 6102 |
| Number Of Medicare Beneficiaries | 1546 |
| Total Submitted Charge Amount | 555172.16 |
| Total Medicare Allowed Amount | 405047.25 |
| Total Medicare Payment Amount | 293925.41 |
| Total Medicare Standardized Payment Amount | 295654.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 123 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 2335 |
| Total Drug Medicare AllowedAmount | 383.44 |
| Total Drug Medicare PaymentAmount | 279.79 |
| Total Drug Medicare Standardized Payment Amount | 279.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 5979 |
| Number Of Medicare Beneficiaries With Medical Services | 1546 |
| Total Medical Submitted Charge Amount | 552837.16 |
| Total Medical Medicare Allowed Amount | 404663.81 |
| Total Medical Medicare Payment Amount | 293645.62 |
| Total Medical Medicare Standardized Payment Amount | 295374.86 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 574 |
| Number Of Beneficiaries Age 75 to 84 | 543 |
| Number Of Beneficiaries Age Greater 84 | 363 |
| Number Of Female Beneficiaries | 935 |
| Number Of Male Beneficiaries | 611 |
| Number Of Non Hispanic White Beneficiaries | 1442 |
| Number Of Black or African American Beneficiaries | 54 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1484 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 62 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3424 |