| National Provider Identifier [NPI]: | 1245229277 |
| Last Name Of The Provider | MADFIS |
| First Name Of The Provider | VADIM |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6320 SAINT AUGUSTINE RD |
| Street Address 2 Of The Provider | UNIT 12 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322172813 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 11658 |
| Number Of Medicare Beneficiaries | 234 |
| Total Submitted Charge Amount | 1376635 |
| Total Medicare Allowed Amount | 611598.77 |
| Total Medicare Payment Amount | 483728.17 |
| Total Medicare Standardized Payment Amount | 492228.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 388 |
| Number Of Medicare Beneficiaries With Drug Services | 187 |
| Total Drug Submitted ChargeAmount | 13082 |
| Total Drug Medicare AllowedAmount | 2379.93 |
| Total Drug Medicare PaymentAmount | 2277.47 |
| Total Drug Medicare Standardized Payment Amount | 2277.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 11270 |
| Number Of Medicare Beneficiaries With Medical Services | 234 |
| Total Medical Submitted Charge Amount | 1363553 |
| Total Medical Medicare Allowed Amount | 609218.84 |
| Total Medical Medicare Payment Amount | 481450.7 |
| Total Medical Medicare Standardized Payment Amount | 489950.88 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 76 |
| Number Of Beneficiaries Age 75 to 84 | 65 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 125 |
| Number Of Male Beneficiaries | 109 |
| Number Of Non Hispanic White Beneficiaries | 184 |
| Number Of Black or African American Beneficiaries | 38 |
| 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 | 110 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 124 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 75 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5668 |