| National Provider Identifier [NPI]: | 1558315069 |
| Last Name Of The Provider | RODRIGUEZ |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 63 BARKLEY CIR |
| Street Address 2 Of The Provider | STE. 100 & 101 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339074514 |
| 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 | 289 |
| Number Of Services | 17683 |
| Number Of Medicare Beneficiaries | 4106 |
| Total Submitted Charge Amount | 966502.3 |
| Total Medicare Allowed Amount | 368582.57 |
| Total Medicare Payment Amount | 290819.6 |
| Total Medicare Standardized Payment Amount | 280690.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 11433 |
| Number Of Medicare Beneficiaries With Drug Services | 138 |
| Total Drug Submitted ChargeAmount | 31455.68 |
| Total Drug Medicare AllowedAmount | 3433.81 |
| Total Drug Medicare PaymentAmount | 2691.94 |
| Total Drug Medicare Standardized Payment Amount | 2691.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 282 |
| Number Of Medical Services | 6250 |
| Number Of Medicare Beneficiaries With Medical Services | 4104 |
| Total Medical Submitted Charge Amount | 935046.62 |
| Total Medical Medicare Allowed Amount | 365148.76 |
| Total Medical Medicare Payment Amount | 288127.66 |
| Total Medical Medicare Standardized Payment Amount | 277998.69 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 460 |
| Number Of Beneficiaries Age 65 to 74 | 1575 |
| Number Of Beneficiaries Age 75 to 84 | 1351 |
| Number Of Beneficiaries Age Greater 84 | 720 |
| Number Of Female Beneficiaries | 2556 |
| Number Of Male Beneficiaries | 1550 |
| Number Of Non Hispanic White Beneficiaries | 3701 |
| Number Of Black or African American Beneficiaries | 145 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 200 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 41 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3434 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 672 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.4932 |