National Provider Identifier [NPI]: |
1609851237 |
Last Name Of The Provider |
RODILES |
First Name Of The Provider |
HORACIO |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2205 ROSS AVE |
Street Address 2 Of The Provider |
STE 101 |
City Of The Provider |
EL CENTRO |
Zip Code Of The Provider |
922433623 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
2249 |
Number Of Medicare Beneficiaries |
244 |
Total Submitted Charge Amount |
630867 |
Total Medicare Allowed Amount |
380080.71 |
Total Medicare Payment Amount |
291942.41 |
Total Medicare Standardized Payment Amount |
284653.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
416 |
Number Of Medicare Beneficiaries With Drug Services |
12 |
Total Drug Submitted ChargeAmount |
11323 |
Total Drug Medicare AllowedAmount |
4806.77 |
Total Drug Medicare PaymentAmount |
3669.56 |
Total Drug Medicare Standardized Payment Amount |
3669.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
14 |
Number Of Medical Services |
1833 |
Number Of Medicare Beneficiaries With Medical Services |
244 |
Total Medical Submitted Charge Amount |
619544 |
Total Medical Medicare Allowed Amount |
375273.94 |
Total Medical Medicare Payment Amount |
288272.85 |
Total Medical Medicare Standardized Payment Amount |
280983.59 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
87 |
Number Of Beneficiaries Age 65 to 74 |
69 |
Number Of Beneficiaries Age 75 to 84 |
54 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
108 |
Number Of Male Beneficiaries |
136 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
210 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
50 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
194 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
51 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
6.4975 |