| National Provider Identifier [NPI]: | 1295708709 |
| Last Name Of The Provider | RIEGODEDIOS |
| First Name Of The Provider | RICARDO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2080 CHILD ST |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322145005 |
| 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 | 151 |
| Number Of Services | 4763 |
| Number Of Medicare Beneficiaries | 3399 |
| Total Submitted Charge Amount | 398210 |
| Total Medicare Allowed Amount | 153753.24 |
| Total Medicare Payment Amount | 115098.1 |
| Total Medicare Standardized Payment Amount | 119428.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 151 |
| Number Of Medical Services | 4763 |
| Number Of Medicare Beneficiaries With Medical Services | 3399 |
| Total Medical Submitted Charge Amount | 398210 |
| Total Medical Medicare Allowed Amount | 153753.24 |
| Total Medical Medicare Payment Amount | 115098.1 |
| Total Medical Medicare Standardized Payment Amount | 119428.39 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 748 |
| Number Of Beneficiaries Age 65 to 74 | 1254 |
| Number Of Beneficiaries Age 75 to 84 | 944 |
| Number Of Beneficiaries Age Greater 84 | 453 |
| Number Of Female Beneficiaries | 2044 |
| Number Of Male Beneficiaries | 1355 |
| Number Of Non Hispanic White Beneficiaries | 3006 |
| Number Of Black or African American Beneficiaries | 331 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2560 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 839 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.54 |