National Provider Identifier [NPI]: |
1124395918 |
Last Name Of The Provider |
RODRIGUEZ |
First Name Of The Provider |
TAMARA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
170 WILLIAM ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW YORK |
Zip Code Of The Provider |
100382612 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
1351 |
Number Of Medicare Beneficiaries |
437 |
Total Submitted Charge Amount |
240174.48 |
Total Medicare Allowed Amount |
124859.59 |
Total Medicare Payment Amount |
96861.88 |
Total Medicare Standardized Payment Amount |
92817.5 |
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 |
18 |
Number Of Medical Services |
1351 |
Number Of Medicare Beneficiaries With Medical Services |
437 |
Total Medical Submitted Charge Amount |
240174.48 |
Total Medical Medicare Allowed Amount |
124859.59 |
Total Medical Medicare Payment Amount |
96861.88 |
Total Medical Medicare Standardized Payment Amount |
92817.5 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
134 |
Number Of Beneficiaries Age 75 to 84 |
151 |
Number Of Beneficiaries Age Greater 84 |
120 |
Number Of Female Beneficiaries |
197 |
Number Of Male Beneficiaries |
240 |
Number Of Non Hispanic White Beneficiaries |
385 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
369 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
68 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
74 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.8077 |