| National Provider Identifier [NPI]: | 1457528697 |
| Last Name Of The Provider | RODRIGUES |
| First Name Of The Provider | SANDRO |
| 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 | 206 EAST BROWN STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | EAST STROUDSBURG |
| Zip Code Of The Provider | 18301 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 122 |
| Number Of Services | 4927 |
| Number Of Medicare Beneficiaries | 2689 |
| Total Submitted Charge Amount | 873887 |
| Total Medicare Allowed Amount | 204019.08 |
| Total Medicare Payment Amount | 156646.78 |
| Total Medicare Standardized Payment Amount | 164106.12 |
| 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 | 122 |
| Number Of Medical Services | 4927 |
| Number Of Medicare Beneficiaries With Medical Services | 2689 |
| Total Medical Submitted Charge Amount | 873887 |
| Total Medical Medicare Allowed Amount | 204019.08 |
| Total Medical Medicare Payment Amount | 156646.78 |
| Total Medical Medicare Standardized Payment Amount | 164106.12 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 647 |
| Number Of Beneficiaries Age 65 to 74 | 844 |
| Number Of Beneficiaries Age 75 to 84 | 755 |
| Number Of Beneficiaries Age Greater 84 | 443 |
| Number Of Female Beneficiaries | 1506 |
| Number Of Male Beneficiaries | 1183 |
| Number Of Non Hispanic White Beneficiaries | 2164 |
| Number Of Black or African American Beneficiaries | 258 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 203 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1940 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 749 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.7557 |