National Provider Identifier [NPI]: |
1528093051 |
Last Name Of The Provider |
RUBAN |
First Name Of The Provider |
IRINA |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 FOREST GLEN RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
SILVER SPRING |
Zip Code Of The Provider |
209101483 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
1926 |
Number Of Medicare Beneficiaries |
598 |
Total Submitted Charge Amount |
397072 |
Total Medicare Allowed Amount |
209976.82 |
Total Medicare Payment Amount |
162658.47 |
Total Medicare Standardized Payment Amount |
149853.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
1926 |
Number Of Medicare Beneficiaries With Medical Services |
598 |
Total Medical Submitted Charge Amount |
397072 |
Total Medical Medicare Allowed Amount |
209976.82 |
Total Medical Medicare Payment Amount |
162658.47 |
Total Medical Medicare Standardized Payment Amount |
149853.89 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
97 |
Number Of Beneficiaries Age 65 to 74 |
145 |
Number Of Beneficiaries Age 75 to 84 |
173 |
Number Of Beneficiaries Age Greater 84 |
183 |
Number Of Female Beneficiaries |
328 |
Number Of Male Beneficiaries |
270 |
Number Of Non Hispanic White Beneficiaries |
292 |
Number Of Black or African American Beneficiaries |
192 |
Number Of AsianPacific Islander Beneficiaries |
38 |
Number Of Hispanic Beneficiaries |
63 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
393 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
205 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
42 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.2726 |