| National Provider Identifier [NPI]: | 1528217395 |
| Last Name Of The Provider | MADSON |
| First Name Of The Provider | JUSTIN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D., PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4242 FARNAM ST. |
| Street Address 2 Of The Provider | SUITE 360 |
| City Of The Provider | OMAHA |
| Zip Code Of The Provider | 681312850 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 13703 |
| Number Of Medicare Beneficiaries | 2211 |
| Total Submitted Charge Amount | 1744336 |
| Total Medicare Allowed Amount | 707053.48 |
| Total Medicare Payment Amount | 503826.98 |
| Total Medicare Standardized Payment Amount | 523448.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 520 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 3120 |
| Total Drug Medicare AllowedAmount | 926.03 |
| Total Drug Medicare PaymentAmount | 665.07 |
| Total Drug Medicare Standardized Payment Amount | 665.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 13183 |
| Number Of Medicare Beneficiaries With Medical Services | 2211 |
| Total Medical Submitted Charge Amount | 1741216 |
| Total Medical Medicare Allowed Amount | 706127.45 |
| Total Medical Medicare Payment Amount | 503161.91 |
| Total Medical Medicare Standardized Payment Amount | 522783.67 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 110 |
| Number Of Beneficiaries Age 65 to 74 | 870 |
| Number Of Beneficiaries Age 75 to 84 | 856 |
| Number Of Beneficiaries Age Greater 84 | 375 |
| Number Of Female Beneficiaries | 1076 |
| Number Of Male Beneficiaries | 1135 |
| Number Of Non Hispanic White Beneficiaries | 2141 |
| Number Of Black or African American Beneficiaries | 28 |
| 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 | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2092 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 119 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9398 |