| National Provider Identifier [NPI]: | 1336374388 |
| Last Name Of The Provider | RODRIGUEZ |
| First Name Of The Provider | ELLANA |
| 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 | 255 W LANCASTER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PAOLI |
| Zip Code Of The Provider | 193011763 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 116 |
| Number Of Services | 3098 |
| Number Of Medicare Beneficiaries | 1717 |
| Total Submitted Charge Amount | 468110.8 |
| Total Medicare Allowed Amount | 109031.75 |
| Total Medicare Payment Amount | 85978.81 |
| Total Medicare Standardized Payment Amount | 82923.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 240 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 1269.8 |
| Total Drug Medicare AllowedAmount | 233.61 |
| Total Drug Medicare PaymentAmount | 183.15 |
| Total Drug Medicare Standardized Payment Amount | 183.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 114 |
| Number Of Medical Services | 2858 |
| Number Of Medicare Beneficiaries With Medical Services | 1717 |
| Total Medical Submitted Charge Amount | 466841 |
| Total Medical Medicare Allowed Amount | 108798.14 |
| Total Medical Medicare Payment Amount | 85795.66 |
| Total Medical Medicare Standardized Payment Amount | 82740.26 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 127 |
| Number Of Beneficiaries Age 65 to 74 | 756 |
| Number Of Beneficiaries Age 75 to 84 | 523 |
| Number Of Beneficiaries Age Greater 84 | 311 |
| Number Of Female Beneficiaries | 1248 |
| Number Of Male Beneficiaries | 469 |
| Number Of Non Hispanic White Beneficiaries | 1576 |
| Number Of Black or African American Beneficiaries | 83 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1571 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 146 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.3078 |