| National Provider Identifier [NPI]: | 1639274814 |
| Last Name Of The Provider | RODRIGUEZ |
| First Name Of The Provider | EDGAR |
| 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 | 576 CALLE CESAR GONZALEZ |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | SAN JUAN |
| Zip Code Of The Provider | 009183756 |
| State Code Of The Provider | PR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 573 |
| Number Of Medicare Beneficiaries | 152 |
| Total Submitted Charge Amount | 33419.16 |
| Total Medicare Allowed Amount | 33374.43 |
| Total Medicare Payment Amount | 23508.62 |
| Total Medicare Standardized Payment Amount | 25668.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 30 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 388.14 |
| Total Drug Medicare AllowedAmount | 343.41 |
| Total Drug Medicare PaymentAmount | 336.54 |
| Total Drug Medicare Standardized Payment Amount | 336.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 543 |
| Number Of Medicare Beneficiaries With Medical Services | 152 |
| Total Medical Submitted Charge Amount | 33031.02 |
| Total Medical Medicare Allowed Amount | 33031.02 |
| Total Medical Medicare Payment Amount | 23172.08 |
| Total Medical Medicare Standardized Payment Amount | 25332.34 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 59 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 94 |
| Number Of Male Beneficiaries | 58 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 53 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 74 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.854 |