| National Provider Identifier [NPI]: | 1881696953 |
| Last Name Of The Provider | RUBIN |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 18530 GRAND RIVER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 482232319 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 4617 |
| Number Of Medicare Beneficiaries | 2169 |
| Total Submitted Charge Amount | 349513.58 |
| Total Medicare Allowed Amount | 239407.46 |
| Total Medicare Payment Amount | 183589.81 |
| Total Medicare Standardized Payment Amount | 182011.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 4617 |
| Number Of Medicare Beneficiaries With Medical Services | 2169 |
| Total Medical Submitted Charge Amount | 349513.58 |
| Total Medical Medicare Allowed Amount | 239407.46 |
| Total Medical Medicare Payment Amount | 183589.81 |
| Total Medical Medicare Standardized Payment Amount | 182011.76 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | 206 |
| Number Of Beneficiaries Age 65 to 74 | 341 |
| Number Of Beneficiaries Age 75 to 84 | 541 |
| Number Of Beneficiaries Age Greater 84 | 1081 |
| Number Of Female Beneficiaries | 1543 |
| Number Of Male Beneficiaries | 626 |
| Number Of Non Hispanic White Beneficiaries | 1573 |
| Number Of Black or African American Beneficiaries | 560 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 906 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1263 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 62 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8752 |