| National Provider Identifier [NPI]: | 1689638629 |
| Last Name Of The Provider | RODICIO |
| First Name Of The Provider | ILEANA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9000 SW 137TH AVE |
| Street Address 2 Of The Provider | SUITE 213 |
| City Of The Provider | MIAMI |
| Zip Code Of The Provider | 331861411 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 5001 |
| Number Of Medicare Beneficiaries | 101 |
| Total Submitted Charge Amount | 139438 |
| Total Medicare Allowed Amount | 86865.89 |
| Total Medicare Payment Amount | 64794.38 |
| Total Medicare Standardized Payment Amount | 62935.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 998 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 29940 |
| Total Drug Medicare AllowedAmount | 26674.67 |
| Total Drug Medicare PaymentAmount | 19108.21 |
| Total Drug Medicare Standardized Payment Amount | 19108.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 4003 |
| Number Of Medicare Beneficiaries With Medical Services | 101 |
| Total Medical Submitted Charge Amount | 109498 |
| Total Medical Medicare Allowed Amount | 60191.22 |
| Total Medical Medicare Payment Amount | 45686.17 |
| Total Medical Medicare Standardized Payment Amount | 43827.57 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 54 |
| Number Of Beneficiaries Age 75 to 84 | 24 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 71 |
| Number Of Male Beneficiaries | 30 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 62 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 36 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2384 |