| National Provider Identifier [NPI]: | 1477588036 |
| Last Name Of The Provider | RIVAS |
| First Name Of The Provider | LUIS |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1611 NW 12TH AVE |
| Street Address 2 Of The Provider | BOX 016960 (M851) |
| City Of The Provider | MIAMI |
| Zip Code Of The Provider | 331361005 |
| 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 | 92 |
| Number Of Services | 2081 |
| Number Of Medicare Beneficiaries | 974 |
| Total Submitted Charge Amount | 241835 |
| Total Medicare Allowed Amount | 56873.92 |
| Total Medicare Payment Amount | 41003.65 |
| Total Medicare Standardized Payment Amount | 39053.02 |
| 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 | 92 |
| Number Of Medical Services | 2081 |
| Number Of Medicare Beneficiaries With Medical Services | 974 |
| Total Medical Submitted Charge Amount | 241835 |
| Total Medical Medicare Allowed Amount | 56873.92 |
| Total Medical Medicare Payment Amount | 41003.65 |
| Total Medical Medicare Standardized Payment Amount | 39053.02 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 415 |
| Number Of Beneficiaries Age 65 to 74 | 305 |
| Number Of Beneficiaries Age 75 to 84 | 172 |
| Number Of Beneficiaries Age Greater 84 | 82 |
| Number Of Female Beneficiaries | 455 |
| Number Of Male Beneficiaries | 519 |
| Number Of Non Hispanic White Beneficiaries | 139 |
| Number Of Black or African American Beneficiaries | 358 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 464 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 128 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 846 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 21 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.7172 |