National Provider Identifier [NPI]: |
1700851243 |
Last Name Of The Provider |
RODRIGUES |
First Name Of The Provider |
GILBERTO |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
N14W23833 STONE RIDGE DR |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
WAUKESHA |
Zip Code Of The Provider |
531881157 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
1418 |
Number Of Medicare Beneficiaries |
382 |
Total Submitted Charge Amount |
174978.4 |
Total Medicare Allowed Amount |
106130.26 |
Total Medicare Payment Amount |
79680.46 |
Total Medicare Standardized Payment Amount |
83089.8 |
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 |
33 |
Number Of Medical Services |
1418 |
Number Of Medicare Beneficiaries With Medical Services |
382 |
Total Medical Submitted Charge Amount |
174978.4 |
Total Medical Medicare Allowed Amount |
106130.26 |
Total Medical Medicare Payment Amount |
79680.46 |
Total Medical Medicare Standardized Payment Amount |
83089.8 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
154 |
Number Of Beneficiaries Age 75 to 84 |
138 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
222 |
Number Of Male Beneficiaries |
160 |
Number Of Non Hispanic White Beneficiaries |
368 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
343 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
43 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.8392 |