National Provider Identifier [NPI]: |
1508864489 |
Last Name Of The Provider |
RODRIGUES |
First Name Of The Provider |
EDISON |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1301 OCEAN DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CORPUS CHRISTI |
Zip Code Of The Provider |
78404 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
1089 |
Number Of Medicare Beneficiaries |
522 |
Total Submitted Charge Amount |
495032.81 |
Total Medicare Allowed Amount |
179068.51 |
Total Medicare Payment Amount |
137781.8 |
Total Medicare Standardized Payment Amount |
145591.93 |
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 |
51 |
Number Of Medical Services |
1089 |
Number Of Medicare Beneficiaries With Medical Services |
522 |
Total Medical Submitted Charge Amount |
495032.81 |
Total Medical Medicare Allowed Amount |
179068.51 |
Total Medical Medicare Payment Amount |
137781.8 |
Total Medical Medicare Standardized Payment Amount |
145591.93 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
124 |
Number Of Beneficiaries Age 65 to 74 |
201 |
Number Of Beneficiaries Age 75 to 84 |
132 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
274 |
Number Of Male Beneficiaries |
248 |
Number Of Non Hispanic White Beneficiaries |
253 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
246 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
338 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
184 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.1104 |