| National Provider Identifier [NPI]: | 1245228121 |
| Last Name Of The Provider | RIDLEN |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | S |
| 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 | 138 |
| Number Of Services | 16043 |
| Number Of Medicare Beneficiaries | 3081 |
| Total Submitted Charge Amount | 834085 |
| Total Medicare Allowed Amount | 285917.16 |
| Total Medicare Payment Amount | 237404.38 |
| Total Medicare Standardized Payment Amount | 230141.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 10951 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 6635 |
| Total Drug Medicare AllowedAmount | 2417.62 |
| Total Drug Medicare PaymentAmount | 1895.2 |
| Total Drug Medicare Standardized Payment Amount | 1895.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 135 |
| Number Of Medical Services | 5092 |
| Number Of Medicare Beneficiaries With Medical Services | 3081 |
| Total Medical Submitted Charge Amount | 827450 |
| Total Medical Medicare Allowed Amount | 283499.54 |
| Total Medical Medicare Payment Amount | 235509.18 |
| Total Medical Medicare Standardized Payment Amount | 228246.21 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 578 |
| Number Of Beneficiaries Age 65 to 74 | 1190 |
| Number Of Beneficiaries Age 75 to 84 | 812 |
| Number Of Beneficiaries Age Greater 84 | 501 |
| Number Of Female Beneficiaries | 2116 |
| Number Of Male Beneficiaries | 965 |
| Number Of Non Hispanic White Beneficiaries | 2544 |
| Number Of Black or African American Beneficiaries | 151 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 297 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 64 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2184 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 897 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4815 |