| National Provider Identifier [NPI]: | 1104898436 |
| Last Name Of The Provider | MADKOUR |
| First Name Of The Provider | AMANDA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11 OLD PARK LANE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW MILFORD |
| Zip Code Of The Provider | 067762507 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 488 |
| Number Of Medicare Beneficiaries | 243 |
| Total Submitted Charge Amount | 44687.5 |
| Total Medicare Allowed Amount | 25996.14 |
| Total Medicare Payment Amount | 18415.42 |
| Total Medicare Standardized Payment Amount | 20332.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 50 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 2103 |
| Total Drug Medicare AllowedAmount | 1021.4 |
| Total Drug Medicare PaymentAmount | 964.03 |
| Total Drug Medicare Standardized Payment Amount | 964.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 438 |
| Number Of Medicare Beneficiaries With Medical Services | 243 |
| Total Medical Submitted Charge Amount | 42584.5 |
| Total Medical Medicare Allowed Amount | 24974.74 |
| Total Medical Medicare Payment Amount | 17451.39 |
| Total Medical Medicare Standardized Payment Amount | 19368.79 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 114 |
| Number Of Beneficiaries Age 75 to 84 | 62 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 183 |
| Number Of Male Beneficiaries | 60 |
| Number Of Non Hispanic White Beneficiaries | 228 |
| Number Of Black or African American Beneficiaries | |
| 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 | 178 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0294 |