| National Provider Identifier [NPI]: | 1851380653 |
| Last Name Of The Provider | BRODY |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 CATAMORE BLVD |
| Street Address 2 Of The Provider | RHODE ISLAND MEDICAL IMAGING |
| City Of The Provider | EAST PROVIDENCE |
| Zip Code Of The Provider | 029141204 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 163 |
| Number Of Services | 14228 |
| Number Of Medicare Beneficiaries | 2272 |
| Total Submitted Charge Amount | 884741 |
| Total Medicare Allowed Amount | 226271.93 |
| Total Medicare Payment Amount | 170928.73 |
| Total Medicare Standardized Payment Amount | 166428.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 10693 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 9961 |
| Total Drug Medicare AllowedAmount | 3933.05 |
| Total Drug Medicare PaymentAmount | 3083.42 |
| Total Drug Medicare Standardized Payment Amount | 3083.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 158 |
| Number Of Medical Services | 3535 |
| Number Of Medicare Beneficiaries With Medical Services | 2272 |
| Total Medical Submitted Charge Amount | 874780 |
| Total Medical Medicare Allowed Amount | 222338.88 |
| Total Medical Medicare Payment Amount | 167845.31 |
| Total Medical Medicare Standardized Payment Amount | 163345.45 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 571 |
| Number Of Beneficiaries Age 65 to 74 | 801 |
| Number Of Beneficiaries Age 75 to 84 | 563 |
| Number Of Beneficiaries Age Greater 84 | 337 |
| Number Of Female Beneficiaries | 1431 |
| Number Of Male Beneficiaries | 841 |
| Number Of Non Hispanic White Beneficiaries | 1823 |
| Number Of Black or African American Beneficiaries | 141 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 225 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 62 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1454 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 818 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.677 |