National Provider Identifier [NPI]: |
1679596530 |
Last Name Of The Provider |
LUBER |
First Name Of The Provider |
HOWARD |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11130 N TATUM BLVD |
Street Address 2 Of The Provider |
#100 |
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
85028 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
15346 |
Number Of Medicare Beneficiaries |
2030 |
Total Submitted Charge Amount |
1067692 |
Total Medicare Allowed Amount |
715696.6 |
Total Medicare Payment Amount |
505247.46 |
Total Medicare Standardized Payment Amount |
501328.03 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
913 |
Number Of Beneficiaries Age 75 to 84 |
791 |
Number Of Beneficiaries Age Greater 84 |
304 |
Number Of Female Beneficiaries |
852 |
Number Of Male Beneficiaries |
1178 |
Number Of Non Hispanic White Beneficiaries |
1974 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
28 |
Number Of Beneficiaries With Medicare Only Entitlement |
2018 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
8 |
Percent Of With Diabetes |
16 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.8839 |