| National Provider Identifier [NPI]: | 1952369779 |
| Last Name Of The Provider | IOANNIDES |
| First Name Of The Provider | TIM |
| 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 | 140 SW CHAMBER CT |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | PORT SAINT LUCIE |
| Zip Code Of The Provider | 349863496 |
| 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 | 73 |
| Number Of Services | 49483 |
| Number Of Medicare Beneficiaries | 2929 |
| Total Submitted Charge Amount | 7039714.89 |
| Total Medicare Allowed Amount | 5732863.73 |
| Total Medicare Payment Amount | 4420785.86 |
| Total Medicare Standardized Payment Amount | 3886174.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2329 |
| Number Of Medicare Beneficiaries With Drug Services | 356 |
| Total Drug Submitted ChargeAmount | 5777.45 |
| Total Drug Medicare AllowedAmount | 5725.69 |
| Total Drug Medicare PaymentAmount | 4349 |
| Total Drug Medicare Standardized Payment Amount | 4349 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 47154 |
| Number Of Medicare Beneficiaries With Medical Services | 2929 |
| Total Medical Submitted Charge Amount | 7033937.44 |
| Total Medical Medicare Allowed Amount | 5727138.04 |
| Total Medical Medicare Payment Amount | 4416436.86 |
| Total Medical Medicare Standardized Payment Amount | 3881825.78 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 137 |
| Number Of Beneficiaries Age 65 to 74 | 1117 |
| Number Of Beneficiaries Age 75 to 84 | 1220 |
| Number Of Beneficiaries Age Greater 84 | 455 |
| Number Of Female Beneficiaries | 1442 |
| Number Of Male Beneficiaries | 1487 |
| Number Of Non Hispanic White Beneficiaries | 2766 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 67 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2768 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 161 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1099 |