| National Provider Identifier [NPI]: | 1427360593 |
| Last Name Of The Provider | ORTIZ-SANTIAGO |
| First Name Of The Provider | MADAI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1613 HARRISON PKWY |
| Street Address 2 Of The Provider | RADIOLOGY DIVISION, SUITE 200 |
| City Of The Provider | SUNRISE |
| Zip Code Of The Provider | 333232896 |
| 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 | 185 |
| Number Of Services | 6905 |
| Number Of Medicare Beneficiaries | 2232 |
| Total Submitted Charge Amount | 1033714.64 |
| Total Medicare Allowed Amount | 194929.89 |
| Total Medicare Payment Amount | 149991.14 |
| Total Medicare Standardized Payment Amount | 145140.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2375 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 3605 |
| Total Drug Medicare AllowedAmount | 868.63 |
| Total Drug Medicare PaymentAmount | 680.95 |
| Total Drug Medicare Standardized Payment Amount | 680.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 182 |
| Number Of Medical Services | 4530 |
| Number Of Medicare Beneficiaries With Medical Services | 2230 |
| Total Medical Submitted Charge Amount | 1030109.64 |
| Total Medical Medicare Allowed Amount | 194061.26 |
| Total Medical Medicare Payment Amount | 149310.19 |
| Total Medical Medicare Standardized Payment Amount | 144459.81 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 445 |
| Number Of Beneficiaries Age 65 to 74 | 720 |
| Number Of Beneficiaries Age 75 to 84 | 610 |
| Number Of Beneficiaries Age Greater 84 | 457 |
| Number Of Female Beneficiaries | 1396 |
| Number Of Male Beneficiaries | 836 |
| Number Of Non Hispanic White Beneficiaries | 1509 |
| Number Of Black or African American Beneficiaries | 444 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 217 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1448 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 784 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.0073 |