| National Provider Identifier [NPI]: | 1346222411 |
| Last Name Of The Provider | MALAVE-VIDAL |
| First Name Of The Provider | IVAN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8900 N KENDALL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MIAMI |
| Zip Code Of The Provider | 331762118 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 9161 |
| Number Of Medicare Beneficiaries | 2652 |
| Total Submitted Charge Amount | 1886056 |
| Total Medicare Allowed Amount | 185635.09 |
| Total Medicare Payment Amount | 139961.62 |
| Total Medicare Standardized Payment Amount | 132326.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 5869 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 33489 |
| Total Drug Medicare AllowedAmount | 1542.77 |
| Total Drug Medicare PaymentAmount | 1172.42 |
| Total Drug Medicare Standardized Payment Amount | 1172.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 96 |
| Number Of Medical Services | 3292 |
| Number Of Medicare Beneficiaries With Medical Services | 2651 |
| Total Medical Submitted Charge Amount | 1852567 |
| Total Medical Medicare Allowed Amount | 184092.32 |
| Total Medical Medicare Payment Amount | 138789.2 |
| Total Medical Medicare Standardized Payment Amount | 131154.53 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 309 |
| Number Of Beneficiaries Age 65 to 74 | 864 |
| Number Of Beneficiaries Age 75 to 84 | 864 |
| Number Of Beneficiaries Age Greater 84 | 615 |
| Number Of Female Beneficiaries | 1717 |
| Number Of Male Beneficiaries | 935 |
| Number Of Non Hispanic White Beneficiaries | 950 |
| Number Of Black or African American Beneficiaries | 135 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 1519 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1310 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1342 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.156 |