| National Provider Identifier [NPI]: | 1912080847 |
| Last Name Of The Provider | MATHIOULAKIS |
| First Name Of The Provider | STAN |
| 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 | 931 BUENA VISTA ST |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | DUARTE |
| Zip Code Of The Provider | 910101712 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 3303 |
| Number Of Medicare Beneficiaries | 272 |
| Total Submitted Charge Amount | 477810 |
| Total Medicare Allowed Amount | 270030.44 |
| Total Medicare Payment Amount | 202634.23 |
| Total Medicare Standardized Payment Amount | 189044.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 39 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 1365 |
| Total Drug Medicare AllowedAmount | 334.62 |
| Total Drug Medicare PaymentAmount | 327.99 |
| Total Drug Medicare Standardized Payment Amount | 327.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 3264 |
| Number Of Medicare Beneficiaries With Medical Services | 272 |
| Total Medical Submitted Charge Amount | 476445 |
| Total Medical Medicare Allowed Amount | 269695.82 |
| Total Medical Medicare Payment Amount | 202306.24 |
| Total Medical Medicare Standardized Payment Amount | 188716.5 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 95 |
| Number Of Beneficiaries Age 75 to 84 | 73 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 165 |
| Number Of Male Beneficiaries | 107 |
| Number Of Non Hispanic White Beneficiaries | 87 |
| Number Of Black or African American Beneficiaries | 47 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 110 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 39 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 233 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 34 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 42 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 65 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.3885 |