National Provider Identifier [NPI]: |
1578576179 |
Last Name Of The Provider |
RODRIGUEZ |
First Name Of The Provider |
ROSANA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DPM |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6 SAINT JOHNS MEDICAL PARK DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
ST AUGUSTINE |
Zip Code Of The Provider |
320864233 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
6452 |
Number Of Medicare Beneficiaries |
421 |
Total Submitted Charge Amount |
710836.5 |
Total Medicare Allowed Amount |
464975.23 |
Total Medicare Payment Amount |
355255.61 |
Total Medicare Standardized Payment Amount |
360008.43 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
391 |
Number Of Medicare Beneficiaries With Drug Services |
36 |
Total Drug Submitted ChargeAmount |
5812.5 |
Total Drug Medicare AllowedAmount |
3005.92 |
Total Drug Medicare PaymentAmount |
2356.6 |
Total Drug Medicare Standardized Payment Amount |
2356.6 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
74 |
Number Of Medical Services |
6061 |
Number Of Medicare Beneficiaries With Medical Services |
421 |
Total Medical Submitted Charge Amount |
705024 |
Total Medical Medicare Allowed Amount |
461969.31 |
Total Medical Medicare Payment Amount |
352899.01 |
Total Medical Medicare Standardized Payment Amount |
357651.83 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
126 |
Number Of Beneficiaries Age 75 to 84 |
131 |
Number Of Beneficiaries Age Greater 84 |
120 |
Number Of Female Beneficiaries |
244 |
Number Of Male Beneficiaries |
177 |
Number Of Non Hispanic White Beneficiaries |
370 |
Number Of Black or African American Beneficiaries |
26 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
358 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
63 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.7971 |