| National Provider Identifier [NPI]: | 1811106826 |
| Last Name Of The Provider | KANTZAVELOS |
| First Name Of The Provider | LOUIS |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1223 S GEAR AVE |
| Street Address 2 Of The Provider | EASTMAN PLAZA SUITE 303 |
| City Of The Provider | WEST BURLINGTON |
| Zip Code Of The Provider | 526551682 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 8999 |
| Number Of Medicare Beneficiaries | 1016 |
| Total Submitted Charge Amount | 1368426 |
| Total Medicare Allowed Amount | 550256.23 |
| Total Medicare Payment Amount | 414737.2 |
| Total Medicare Standardized Payment Amount | 438002.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 4995 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 318713 |
| Total Drug Medicare AllowedAmount | 170397.61 |
| Total Drug Medicare PaymentAmount | 132629.01 |
| Total Drug Medicare Standardized Payment Amount | 132629.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 4004 |
| Number Of Medicare Beneficiaries With Medical Services | 1016 |
| Total Medical Submitted Charge Amount | 1049713 |
| Total Medical Medicare Allowed Amount | 379858.62 |
| Total Medical Medicare Payment Amount | 282108.19 |
| Total Medical Medicare Standardized Payment Amount | 305373.26 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 427 |
| Number Of Beneficiaries Age 75 to 84 | 366 |
| Number Of Beneficiaries Age Greater 84 | 151 |
| Number Of Female Beneficiaries | 217 |
| Number Of Male Beneficiaries | 799 |
| Number Of Non Hispanic White Beneficiaries | 974 |
| Number Of Black or African American Beneficiaries | 18 |
| 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 | 914 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 102 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 2 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.255 |