| National Provider Identifier [NPI]: | 1467683227 |
| Last Name Of The Provider | VAFIDIS |
| First Name Of The Provider | CONSTANTINE |
| 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 | 1524 ATWOOD AVE STE 225 |
| Street Address 2 Of The Provider | |
| City Of The Provider | JOHNSTON |
| Zip Code Of The Provider | 029193228 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 974 |
| Number Of Medicare Beneficiaries | 210 |
| Total Submitted Charge Amount | 102880 |
| Total Medicare Allowed Amount | 73670.76 |
| Total Medicare Payment Amount | 53515.59 |
| Total Medicare Standardized Payment Amount | 51952.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 72 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 966 |
| Total Drug Medicare AllowedAmount | 340.65 |
| Total Drug Medicare PaymentAmount | 313.91 |
| Total Drug Medicare Standardized Payment Amount | 313.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 902 |
| Number Of Medicare Beneficiaries With Medical Services | 210 |
| Total Medical Submitted Charge Amount | 101914 |
| Total Medical Medicare Allowed Amount | 73330.11 |
| Total Medical Medicare Payment Amount | 53201.68 |
| Total Medical Medicare Standardized Payment Amount | 51639.06 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 93 |
| Number Of Beneficiaries Age 65 to 74 | 65 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 126 |
| Number Of Male Beneficiaries | 84 |
| Number Of Non Hispanic White Beneficiaries | 180 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 102 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 108 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1323 |