| National Provider Identifier [NPI]: | 1992753628 |
| Last Name Of The Provider | RODRIGUEZ |
| First Name Of The Provider | RENE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8201 W BROWARD BOULEVARD |
| Street Address 2 Of The Provider | WESTSIDE REGIONAL MEDICAL CENTER |
| City Of The Provider | PLANTATION |
| Zip Code Of The Provider | 33324 |
| 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 | 74 |
| Number Of Services | 1122 |
| Number Of Medicare Beneficiaries | 841 |
| Total Submitted Charge Amount | 99121 |
| Total Medicare Allowed Amount | 18076.9 |
| Total Medicare Payment Amount | 13791.96 |
| Total Medicare Standardized Payment Amount | 13196.08 |
| 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 | 74 |
| Number Of Medical Services | 1122 |
| Number Of Medicare Beneficiaries With Medical Services | 841 |
| Total Medical Submitted Charge Amount | 99121 |
| Total Medical Medicare Allowed Amount | 18076.9 |
| Total Medical Medicare Payment Amount | 13791.96 |
| Total Medical Medicare Standardized Payment Amount | 13196.08 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 233 |
| Number Of Beneficiaries Age 75 to 84 | 245 |
| Number Of Beneficiaries Age Greater 84 | 247 |
| Number Of Female Beneficiaries | 501 |
| Number Of Male Beneficiaries | 340 |
| Number Of Non Hispanic White Beneficiaries | 606 |
| Number Of Black or African American Beneficiaries | 122 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 84 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 632 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 209 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.1834 |