| National Provider Identifier [NPI]: | 1811158256 |
| Last Name Of The Provider | HODGE |
| First Name Of The Provider | JACOB |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 1ST ST SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCHESTER |
| Zip Code Of The Provider | 559050001 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 144 |
| Number Of Services | 15438 |
| Number Of Medicare Beneficiaries | 1719 |
| Total Submitted Charge Amount | 677176.26 |
| Total Medicare Allowed Amount | 213904.79 |
| Total Medicare Payment Amount | 161736.61 |
| Total Medicare Standardized Payment Amount | 165377.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 12132 |
| Number Of Medicare Beneficiaries With Drug Services | 188 |
| Total Drug Submitted ChargeAmount | 26465 |
| Total Drug Medicare AllowedAmount | 3936.82 |
| Total Drug Medicare PaymentAmount | 3030.69 |
| Total Drug Medicare Standardized Payment Amount | 3030.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 139 |
| Number Of Medical Services | 3306 |
| Number Of Medicare Beneficiaries With Medical Services | 1719 |
| Total Medical Submitted Charge Amount | 650711.26 |
| Total Medical Medicare Allowed Amount | 209967.97 |
| Total Medical Medicare Payment Amount | 158705.92 |
| Total Medical Medicare Standardized Payment Amount | 162346.93 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 185 |
| Number Of Beneficiaries Age 65 to 74 | 829 |
| Number Of Beneficiaries Age 75 to 84 | 478 |
| Number Of Beneficiaries Age Greater 84 | 227 |
| Number Of Female Beneficiaries | 989 |
| Number Of Male Beneficiaries | 730 |
| Number Of Non Hispanic White Beneficiaries | 1604 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | 17 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1525 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 194 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0999 |