| National Provider Identifier [NPI]: | 1780690867 |
| Last Name Of The Provider | LAGOUTARIS |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 KINGSLEY LAKE DR |
| Street Address 2 Of The Provider | STE. 402 |
| City Of The Provider | SAINT AUGUSTINE |
| Zip Code Of The Provider | 320923037 |
| 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 | 38 |
| Number Of Services | 1992 |
| Number Of Medicare Beneficiaries | 500 |
| Total Submitted Charge Amount | 162467.3 |
| Total Medicare Allowed Amount | 100562.35 |
| Total Medicare Payment Amount | 74245.11 |
| Total Medicare Standardized Payment Amount | 74375.2 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 82 |
| Number Of Beneficiaries Age 75 to 84 | 154 |
| Number Of Beneficiaries Age Greater 84 | 243 |
| Number Of Female Beneficiaries | 273 |
| Number Of Male Beneficiaries | 227 |
| Number Of Non Hispanic White Beneficiaries | 463 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 380 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 120 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 50 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9547 |