| National Provider Identifier [NPI]: | 1699749358 |
| Last Name Of The Provider | KODESCH |
| First Name Of The Provider | LINDA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4300 GARDEN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | TITUSVILLE |
| Zip Code Of The Provider | 327962937 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 1949 |
| Number Of Medicare Beneficiaries | 212 |
| Total Submitted Charge Amount | 70136 |
| Total Medicare Allowed Amount | 51580.68 |
| Total Medicare Payment Amount | 38360.62 |
| Total Medicare Standardized Payment Amount | 38989.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 734 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 23956 |
| Total Drug Medicare AllowedAmount | 19572.82 |
| Total Drug Medicare PaymentAmount | 15307.26 |
| Total Drug Medicare Standardized Payment Amount | 15307.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 1215 |
| Number Of Medicare Beneficiaries With Medical Services | 212 |
| Total Medical Submitted Charge Amount | 46180 |
| Total Medical Medicare Allowed Amount | 32007.86 |
| Total Medical Medicare Payment Amount | 23053.36 |
| Total Medical Medicare Standardized Payment Amount | 23681.91 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 105 |
| Number Of Beneficiaries Age 75 to 84 | 70 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 136 |
| Number Of Male Beneficiaries | 76 |
| Number Of Non Hispanic White Beneficiaries | 195 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 201 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9545 |