National Provider Identifier [NPI]: |
1518077452 |
Last Name Of The Provider |
RUBIN |
First Name Of The Provider |
JUDITH |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3978 SORRENTO VALLEY BLVD |
Street Address 2 Of The Provider |
SUITE 310 |
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921211436 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
584 |
Number Of Medicare Beneficiaries |
88 |
Total Submitted Charge Amount |
48765 |
Total Medicare Allowed Amount |
23779.41 |
Total Medicare Payment Amount |
15030.37 |
Total Medicare Standardized Payment Amount |
15609.04 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
350 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
3984 |
Total Drug Medicare AllowedAmount |
2419.34 |
Total Drug Medicare PaymentAmount |
2037.72 |
Total Drug Medicare Standardized Payment Amount |
2037.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
234 |
Number Of Medicare Beneficiaries With Medical Services |
88 |
Total Medical Submitted Charge Amount |
44781 |
Total Medical Medicare Allowed Amount |
21360.07 |
Total Medical Medicare Payment Amount |
12992.65 |
Total Medical Medicare Standardized Payment Amount |
13571.32 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
75 |
Number Of Male Beneficiaries |
13 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
74 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
13 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
43 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.8759 |