| National Provider Identifier [NPI]: | 1073575858 |
| Last Name Of The Provider | RODAN |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 WATERBRIDGE LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | JUPITER |
| Zip Code Of The Provider | 334587743 |
| 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 | 70 |
| Number Of Services | 2988 |
| Number Of Medicare Beneficiaries | 1728 |
| Total Submitted Charge Amount | 299451.92 |
| Total Medicare Allowed Amount | 110293.89 |
| Total Medicare Payment Amount | 85109.06 |
| Total Medicare Standardized Payment Amount | 82056.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 784 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 2376 |
| Total Drug Medicare AllowedAmount | 541.55 |
| Total Drug Medicare PaymentAmount | 421.65 |
| Total Drug Medicare Standardized Payment Amount | 421.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 2204 |
| Number Of Medicare Beneficiaries With Medical Services | 1727 |
| Total Medical Submitted Charge Amount | 297075.92 |
| Total Medical Medicare Allowed Amount | 109752.34 |
| Total Medical Medicare Payment Amount | 84687.41 |
| Total Medical Medicare Standardized Payment Amount | 81635.33 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 80 |
| Number Of Beneficiaries Age 65 to 74 | 655 |
| Number Of Beneficiaries Age 75 to 84 | 713 |
| Number Of Beneficiaries Age Greater 84 | 280 |
| Number Of Female Beneficiaries | 1009 |
| Number Of Male Beneficiaries | 719 |
| Number Of Non Hispanic White Beneficiaries | 1595 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 61 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1636 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1447 |