| National Provider Identifier [NPI]: | 1912933870 |
| Last Name Of The Provider | MADONNA |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1506 ALICE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WAYCROSS |
| Zip Code Of The Provider | 315014531 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 2850 |
| Number Of Medicare Beneficiaries | 959 |
| Total Submitted Charge Amount | 1002222 |
| Total Medicare Allowed Amount | 306383.6 |
| Total Medicare Payment Amount | 224904.88 |
| Total Medicare Standardized Payment Amount | 249360.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 448 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 72128 |
| Total Drug Medicare AllowedAmount | 23726.05 |
| Total Drug Medicare PaymentAmount | 18127.51 |
| Total Drug Medicare Standardized Payment Amount | 18127.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 2402 |
| Number Of Medicare Beneficiaries With Medical Services | 959 |
| Total Medical Submitted Charge Amount | 930094 |
| Total Medical Medicare Allowed Amount | 282657.55 |
| Total Medical Medicare Payment Amount | 206777.37 |
| Total Medical Medicare Standardized Payment Amount | 231233.1 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 155 |
| Number Of Beneficiaries Age 65 to 74 | 316 |
| Number Of Beneficiaries Age 75 to 84 | 334 |
| Number Of Beneficiaries Age Greater 84 | 154 |
| Number Of Female Beneficiaries | 506 |
| Number Of Male Beneficiaries | 453 |
| Number Of Non Hispanic White Beneficiaries | 831 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 651 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 308 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.8052 |