| National Provider Identifier [NPI]: | 1194703298 |
| Last Name Of The Provider | RUBINLICHT |
| First Name Of The Provider | JACK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1304 RHAWN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHILA |
| Zip Code Of The Provider | 191112870 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 5332 |
| Number Of Medicare Beneficiaries | 955 |
| Total Submitted Charge Amount | 403265 |
| Total Medicare Allowed Amount | 244653.37 |
| Total Medicare Payment Amount | 188245.98 |
| Total Medicare Standardized Payment Amount | 179772.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 39 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 585 |
| Total Drug Medicare AllowedAmount | 222.16 |
| Total Drug Medicare PaymentAmount | 169.69 |
| Total Drug Medicare Standardized Payment Amount | 169.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 5293 |
| Number Of Medicare Beneficiaries With Medical Services | 955 |
| Total Medical Submitted Charge Amount | 402680 |
| Total Medical Medicare Allowed Amount | 244431.21 |
| Total Medical Medicare Payment Amount | 188076.29 |
| Total Medical Medicare Standardized Payment Amount | 179602.35 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 115 |
| Number Of Beneficiaries Age 65 to 74 | 319 |
| Number Of Beneficiaries Age 75 to 84 | 311 |
| Number Of Beneficiaries Age Greater 84 | 210 |
| Number Of Female Beneficiaries | 536 |
| Number Of Male Beneficiaries | 419 |
| Number Of Non Hispanic White Beneficiaries | 839 |
| Number Of Black or African American Beneficiaries | 38 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 59 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 799 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 156 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4592 |