| National Provider Identifier [NPI]: | 1134129505 |
| Last Name Of The Provider | VASILOUDES |
| First Name Of The Provider | PANAYIOTIS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5210 WEBB RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336154518 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 13311 |
| Number Of Medicare Beneficiaries | 2877 |
| Total Submitted Charge Amount | 3019706.63 |
| Total Medicare Allowed Amount | 709341.25 |
| Total Medicare Payment Amount | 547238.73 |
| Total Medicare Standardized Payment Amount | 465685.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 1450 |
| Total Drug Medicare AllowedAmount | 51.72 |
| Total Drug Medicare PaymentAmount | 39.16 |
| Total Drug Medicare Standardized Payment Amount | 39.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 13282 |
| Number Of Medicare Beneficiaries With Medical Services | 2877 |
| Total Medical Submitted Charge Amount | 3018256.63 |
| Total Medical Medicare Allowed Amount | 709289.53 |
| Total Medical Medicare Payment Amount | 547199.57 |
| Total Medical Medicare Standardized Payment Amount | 465646.57 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 145 |
| Number Of Beneficiaries Age 65 to 74 | 1316 |
| Number Of Beneficiaries Age 75 to 84 | 986 |
| Number Of Beneficiaries Age Greater 84 | 430 |
| Number Of Female Beneficiaries | 1541 |
| Number Of Male Beneficiaries | 1336 |
| Number Of Non Hispanic White Beneficiaries | 2691 |
| Number Of Black or African American Beneficiaries | 43 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 96 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2723 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 154 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.068 |