| National Provider Identifier [NPI]: | 1811043003 |
| Last Name Of The Provider | AUGOUSTINIATOS |
| First Name Of The Provider | EVANGELIA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 TERRY ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SMITHTOWN |
| Zip Code Of The Provider | 117873811 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 2884 |
| Number Of Medicare Beneficiaries | 492 |
| Total Submitted Charge Amount | 405477.67 |
| Total Medicare Allowed Amount | 240865.52 |
| Total Medicare Payment Amount | 183152.6 |
| Total Medicare Standardized Payment Amount | 161760.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 251 |
| Number Of Medicare Beneficiaries With Drug Services | 213 |
| Total Drug Submitted ChargeAmount | 8463 |
| Total Drug Medicare AllowedAmount | 3831.69 |
| Total Drug Medicare PaymentAmount | 3727.01 |
| Total Drug Medicare Standardized Payment Amount | 3727.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 2633 |
| Number Of Medicare Beneficiaries With Medical Services | 492 |
| Total Medical Submitted Charge Amount | 397014.67 |
| Total Medical Medicare Allowed Amount | 237033.83 |
| Total Medical Medicare Payment Amount | 179425.59 |
| Total Medical Medicare Standardized Payment Amount | 158033.12 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 279 |
| Number Of Beneficiaries Age 75 to 84 | 132 |
| Number Of Beneficiaries Age Greater 84 | 56 |
| Number Of Female Beneficiaries | 379 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | 464 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 471 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9196 |