| National Provider Identifier [NPI]: | 1700882479 |
| Last Name Of The Provider | RUBIN |
| First Name Of The Provider | JACK |
| 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 | 10941 BLOOMFIELD ST |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | LOS ALAMITOS |
| Zip Code Of The Provider | 907202530 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 9776 |
| Number Of Medicare Beneficiaries | 946 |
| Total Submitted Charge Amount | 1513199 |
| Total Medicare Allowed Amount | 1030070.53 |
| Total Medicare Payment Amount | 799250.13 |
| Total Medicare Standardized Payment Amount | 740551.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 245 |
| Number Of Medicare Beneficiaries With Drug Services | 124 |
| Total Drug Submitted ChargeAmount | 5879 |
| Total Drug Medicare AllowedAmount | 3803.02 |
| Total Drug Medicare PaymentAmount | 3670.13 |
| Total Drug Medicare Standardized Payment Amount | 3670.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 9531 |
| Number Of Medicare Beneficiaries With Medical Services | 945 |
| Total Medical Submitted Charge Amount | 1507320 |
| Total Medical Medicare Allowed Amount | 1026267.51 |
| Total Medical Medicare Payment Amount | 795580 |
| Total Medical Medicare Standardized Payment Amount | 736881.32 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 183 |
| Number Of Beneficiaries Age 65 to 74 | 275 |
| Number Of Beneficiaries Age 75 to 84 | 270 |
| Number Of Beneficiaries Age Greater 84 | 218 |
| Number Of Female Beneficiaries | 467 |
| Number Of Male Beneficiaries | 479 |
| Number Of Non Hispanic White Beneficiaries | 433 |
| Number Of Black or African American Beneficiaries | 141 |
| Number Of AsianPacific Islander Beneficiaries | 135 |
| Number Of Hispanic Beneficiaries | 219 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 375 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 571 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 39 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 70 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 64 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 26 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 3.6228 |