| National Provider Identifier [NPI]: | 1720036312 |
| Last Name Of The Provider | RUBIN |
| First Name Of The Provider | J |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11209 N TATUM BLVD |
| Street Address 2 Of The Provider | SUITE # 110 |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850283091 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 223 |
| Number Of Services | 6505 |
| Number Of Medicare Beneficiaries | 3766 |
| Total Submitted Charge Amount | 711568 |
| Total Medicare Allowed Amount | 195115.95 |
| Total Medicare Payment Amount | 145597.11 |
| Total Medicare Standardized Payment Amount | 153746.91 |
| 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 | 223 |
| Number Of Medical Services | 6505 |
| Number Of Medicare Beneficiaries With Medical Services | 3766 |
| Total Medical Submitted Charge Amount | 711568 |
| Total Medical Medicare Allowed Amount | 195115.95 |
| Total Medical Medicare Payment Amount | 145597.11 |
| Total Medical Medicare Standardized Payment Amount | 153746.91 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 944 |
| Number Of Beneficiaries Age 65 to 74 | 1312 |
| Number Of Beneficiaries Age 75 to 84 | 1024 |
| Number Of Beneficiaries Age Greater 84 | 486 |
| Number Of Female Beneficiaries | 2173 |
| Number Of Male Beneficiaries | 1593 |
| Number Of Non Hispanic White Beneficiaries | 3482 |
| Number Of Black or African American Beneficiaries | 237 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2245 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1521 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.7599 |