| National Provider Identifier [NPI]: | 1700879897 |
| Last Name Of The Provider | HERNANDEZ |
| First Name Of The Provider | RUBEN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 43839 15TH ST W |
| Street Address 2 Of The Provider | |
| City Of The Provider | LANCASTER |
| Zip Code Of The Provider | 935344756 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 588 |
| Number Of Medicare Beneficiaries | 133 |
| Total Submitted Charge Amount | 35986.19 |
| Total Medicare Allowed Amount | 28415.28 |
| Total Medicare Payment Amount | 17947.67 |
| Total Medicare Standardized Payment Amount | 16683.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 165 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 1574.15 |
| Total Drug Medicare AllowedAmount | 957.35 |
| Total Drug Medicare PaymentAmount | 851.92 |
| Total Drug Medicare Standardized Payment Amount | 851.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 423 |
| Number Of Medicare Beneficiaries With Medical Services | 133 |
| Total Medical Submitted Charge Amount | 34412.04 |
| Total Medical Medicare Allowed Amount | 27457.93 |
| Total Medical Medicare Payment Amount | 17095.75 |
| Total Medical Medicare Standardized Payment Amount | 15831.31 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 69 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 76 |
| Number Of Male Beneficiaries | 57 |
| Number Of Non Hispanic White Beneficiaries | 52 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 60 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 52 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1576 |