| National Provider Identifier [NPI]: | 1730106659 |
| Last Name Of The Provider | TUBMAN |
| First Name Of The Provider | GARY |
| 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 | 1200 WATERS PL |
| Street Address 2 Of The Provider | SUITE M108 |
| City Of The Provider | BRONX |
| Zip Code Of The Provider | 104612728 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 119 |
| Number Of Services | 5593 |
| Number Of Medicare Beneficiaries | 1206 |
| Total Submitted Charge Amount | 1881603.98 |
| Total Medicare Allowed Amount | 363638.66 |
| Total Medicare Payment Amount | 284560.87 |
| Total Medicare Standardized Payment Amount | 241112.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 3737 |
| Number Of Medicare Beneficiaries With Drug Services | 177 |
| Total Drug Submitted ChargeAmount | 26648 |
| Total Drug Medicare AllowedAmount | 3681.07 |
| Total Drug Medicare PaymentAmount | 2885.81 |
| Total Drug Medicare Standardized Payment Amount | 2885.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 115 |
| Number Of Medical Services | 1856 |
| Number Of Medicare Beneficiaries With Medical Services | 1206 |
| Total Medical Submitted Charge Amount | 1854955.98 |
| Total Medical Medicare Allowed Amount | 359957.59 |
| Total Medical Medicare Payment Amount | 281675.06 |
| Total Medical Medicare Standardized Payment Amount | 238226.45 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 212 |
| Number Of Beneficiaries Age 65 to 74 | 510 |
| Number Of Beneficiaries Age 75 to 84 | 356 |
| Number Of Beneficiaries Age Greater 84 | 128 |
| Number Of Female Beneficiaries | 810 |
| Number Of Male Beneficiaries | 396 |
| Number Of Non Hispanic White Beneficiaries | 507 |
| Number Of Black or African American Beneficiaries | 284 |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 346 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 842 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 364 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.309 |