National Provider Identifier [NPI]: |
1922179639 |
Last Name Of The Provider |
RUBINSTEIN |
First Name Of The Provider |
RITA |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
340 W CENTRAL AVE |
Street Address 2 Of The Provider |
#138 |
City Of The Provider |
BREA |
Zip Code Of The Provider |
92821 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
962 |
Number Of Medicare Beneficiaries |
165 |
Total Submitted Charge Amount |
75582 |
Total Medicare Allowed Amount |
65305.04 |
Total Medicare Payment Amount |
44758.75 |
Total Medicare Standardized Payment Amount |
41186.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
19 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
605 |
Total Drug Medicare AllowedAmount |
183.98 |
Total Drug Medicare PaymentAmount |
158.54 |
Total Drug Medicare Standardized Payment Amount |
158.54 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
22 |
Number Of Medical Services |
943 |
Number Of Medicare Beneficiaries With Medical Services |
165 |
Total Medical Submitted Charge Amount |
74977 |
Total Medical Medicare Allowed Amount |
65121.06 |
Total Medical Medicare Payment Amount |
44600.21 |
Total Medical Medicare Standardized Payment Amount |
41027.95 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
38 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
47 |
Number Of Non Hispanic White Beneficiaries |
132 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
13 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
|
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
7 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7389 |