| National Provider Identifier [NPI]: | 1235176637 |
| Last Name Of The Provider | MADRID |
| First Name Of The Provider | RAMON |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2040 MONROE ST |
| Street Address 2 Of The Provider | SUITE #209 |
| City Of The Provider | DEARBORN |
| Zip Code Of The Provider | 481242921 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 2346 |
| Number Of Medicare Beneficiaries | 514 |
| Total Submitted Charge Amount | 463948 |
| Total Medicare Allowed Amount | 247583.24 |
| Total Medicare Payment Amount | 192505.16 |
| Total Medicare Standardized Payment Amount | 186976.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 111 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 610 |
| Total Drug Medicare AllowedAmount | 166.45 |
| Total Drug Medicare PaymentAmount | 132.81 |
| Total Drug Medicare Standardized Payment Amount | 132.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 2235 |
| Number Of Medicare Beneficiaries With Medical Services | 513 |
| Total Medical Submitted Charge Amount | 463338 |
| Total Medical Medicare Allowed Amount | 247416.79 |
| Total Medical Medicare Payment Amount | 192372.35 |
| Total Medical Medicare Standardized Payment Amount | 186844.08 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 324 |
| Number Of Beneficiaries Age 65 to 74 | 125 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 251 |
| Number Of Male Beneficiaries | 263 |
| Number Of Non Hispanic White Beneficiaries | 27 |
| Number Of Black or African American Beneficiaries | 475 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 144 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 370 |
| Percent Of With Atrial Fibrillation | 3 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 45 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 50 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 60 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.9048 |