| National Provider Identifier [NPI]: | 1568466902 |
| Last Name Of The Provider | RODRIGUEZ |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5340 HOLY CROSS PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | MISHAWAKA |
| Zip Code Of The Provider | 465451470 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gynecological/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 146 |
| Number Of Services | 102749 |
| Number Of Medicare Beneficiaries | 407 |
| Total Submitted Charge Amount | 3660994 |
| Total Medicare Allowed Amount | 1369070.35 |
| Total Medicare Payment Amount | 1059245.94 |
| Total Medicare Standardized Payment Amount | 1065004.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 74 |
| Number Of Drug Services | 97296 |
| Number Of Medicare Beneficiaries With Drug Services | 244 |
| Total Drug Submitted ChargeAmount | 3055687 |
| Total Drug Medicare AllowedAmount | 1172214.39 |
| Total Drug Medicare PaymentAmount | 910215.12 |
| Total Drug Medicare Standardized Payment Amount | 910215.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 5453 |
| Number Of Medicare Beneficiaries With Medical Services | 407 |
| Total Medical Submitted Charge Amount | 605307 |
| Total Medical Medicare Allowed Amount | 196855.96 |
| Total Medical Medicare Payment Amount | 149030.82 |
| Total Medical Medicare Standardized Payment Amount | 154789.32 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 201 |
| Number Of Beneficiaries Age 75 to 84 | 116 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 321 |
| Number Of Male Beneficiaries | 86 |
| Number Of Non Hispanic White Beneficiaries | 375 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 343 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 34 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 2.1172 |