| National Provider Identifier [NPI]: | 1164410916 |
| Last Name Of The Provider | RIVERA |
| First Name Of The Provider | CALEB |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1818 SW 15TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | OCALA |
| Zip Code Of The Provider | 344743548 |
| 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 | 244 |
| Number Of Services | 11360 |
| Number Of Medicare Beneficiaries | 4256 |
| Total Submitted Charge Amount | 930572.6 |
| Total Medicare Allowed Amount | 280148.7 |
| Total Medicare Payment Amount | 204915.2 |
| Total Medicare Standardized Payment Amount | 206889.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 4124 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 10751 |
| Total Drug Medicare AllowedAmount | 953.16 |
| Total Drug Medicare PaymentAmount | 733.68 |
| Total Drug Medicare Standardized Payment Amount | 733.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 242 |
| Number Of Medical Services | 7236 |
| Number Of Medicare Beneficiaries With Medical Services | 4255 |
| Total Medical Submitted Charge Amount | 919821.6 |
| Total Medical Medicare Allowed Amount | 279195.54 |
| Total Medical Medicare Payment Amount | 204181.52 |
| Total Medical Medicare Standardized Payment Amount | 206156.08 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 692 |
| Number Of Beneficiaries Age 65 to 74 | 1231 |
| Number Of Beneficiaries Age 75 to 84 | 1444 |
| Number Of Beneficiaries Age Greater 84 | 889 |
| Number Of Female Beneficiaries | 2379 |
| Number Of Male Beneficiaries | 1877 |
| Number Of Non Hispanic White Beneficiaries | 3681 |
| Number Of Black or African American Beneficiaries | 342 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 180 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3132 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1124 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.0082 |