| National Provider Identifier [NPI]: | 1831306760 |
| Last Name Of The Provider | RODRIGUEZ |
| First Name Of The Provider | CAMILLE |
| 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 | 1301 W 7TH ST |
| Street Address 2 Of The Provider | SUITE 121A |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761022651 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 1552 |
| Number Of Medicare Beneficiaries | 653 |
| Total Submitted Charge Amount | 115295 |
| Total Medicare Allowed Amount | 92538.16 |
| Total Medicare Payment Amount | 63309.41 |
| Total Medicare Standardized Payment Amount | 66002.89 |
| 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 | 18 |
| Number Of Medical Services | 1552 |
| Number Of Medicare Beneficiaries With Medical Services | 653 |
| Total Medical Submitted Charge Amount | 115295 |
| Total Medical Medicare Allowed Amount | 92538.16 |
| Total Medical Medicare Payment Amount | 63309.41 |
| Total Medical Medicare Standardized Payment Amount | 66002.89 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 138 |
| Number Of Beneficiaries Age 65 to 74 | 164 |
| Number Of Beneficiaries Age 75 to 84 | 172 |
| Number Of Beneficiaries Age Greater 84 | 179 |
| Number Of Female Beneficiaries | 431 |
| Number Of Male Beneficiaries | 222 |
| Number Of Non Hispanic White Beneficiaries | 390 |
| Number Of Black or African American Beneficiaries | 181 |
| 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 | 328 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 325 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 42 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 69 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 68 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.6883 |