| National Provider Identifier [NPI]: | 1982789111 |
| Last Name Of The Provider | DUBIN |
| First Name Of The Provider | LAWRENCE |
| 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 | 2000 E LAYTON AVE |
| Street Address 2 Of The Provider | STE #130 |
| City Of The Provider | ST FRANCIS |
| Zip Code Of The Provider | 532356053 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 158 |
| Number Of Services | 34334 |
| Number Of Medicare Beneficiaries | 2827 |
| Total Submitted Charge Amount | 5541680.94 |
| Total Medicare Allowed Amount | 510067.47 |
| Total Medicare Payment Amount | 389791.7 |
| Total Medicare Standardized Payment Amount | 415713.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 29150 |
| Number Of Medicare Beneficiaries With Drug Services | 339 |
| Total Drug Submitted ChargeAmount | 84112 |
| Total Drug Medicare AllowedAmount | 14649.01 |
| Total Drug Medicare PaymentAmount | 10990.44 |
| Total Drug Medicare Standardized Payment Amount | 10990.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 155 |
| Number Of Medical Services | 5184 |
| Number Of Medicare Beneficiaries With Medical Services | 2827 |
| Total Medical Submitted Charge Amount | 5457568.94 |
| Total Medical Medicare Allowed Amount | 495418.46 |
| Total Medical Medicare Payment Amount | 378801.26 |
| Total Medical Medicare Standardized Payment Amount | 404723.33 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 499 |
| Number Of Beneficiaries Age 65 to 74 | 1136 |
| Number Of Beneficiaries Age 75 to 84 | 801 |
| Number Of Beneficiaries Age Greater 84 | 391 |
| Number Of Female Beneficiaries | 1965 |
| Number Of Male Beneficiaries | 862 |
| Number Of Non Hispanic White Beneficiaries | 2508 |
| Number Of Black or African American Beneficiaries | 50 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | 185 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2300 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 527 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1664 |