National Provider Identifier [NPI]: |
1932356078 |
Last Name Of The Provider |
RODRIGUEZ |
First Name Of The Provider |
SHAUNDA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1947 N FOUNDERS CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
WICHITA |
Zip Code Of The Provider |
672063548 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
63 |
Number Of Services |
1373 |
Number Of Medicare Beneficiaries |
383 |
Total Submitted Charge Amount |
401673 |
Total Medicare Allowed Amount |
142214.93 |
Total Medicare Payment Amount |
109277.72 |
Total Medicare Standardized Payment Amount |
117063.67 |
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 |
63 |
Number Of Medical Services |
1373 |
Number Of Medicare Beneficiaries With Medical Services |
383 |
Total Medical Submitted Charge Amount |
401673 |
Total Medical Medicare Allowed Amount |
142214.93 |
Total Medical Medicare Payment Amount |
109277.72 |
Total Medical Medicare Standardized Payment Amount |
117063.67 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
125 |
Number Of Beneficiaries Age 75 to 84 |
128 |
Number Of Beneficiaries Age Greater 84 |
84 |
Number Of Female Beneficiaries |
218 |
Number Of Male Beneficiaries |
165 |
Number Of Non Hispanic White Beneficiaries |
371 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
311 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0627 |