| National Provider Identifier [NPI]: | 1366446890 |
| Last Name Of The Provider | TRUBEK |
| First Name Of The Provider | SIMON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12554 RIATA VISTA CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787276431 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 164 |
| Number Of Services | 16692 |
| Number Of Medicare Beneficiaries | 3412 |
| Total Submitted Charge Amount | 1482151.61 |
| Total Medicare Allowed Amount | 412469.21 |
| Total Medicare Payment Amount | 313187.63 |
| Total Medicare Standardized Payment Amount | 320723.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 11829 |
| Number Of Medicare Beneficiaries With Drug Services | 146 |
| Total Drug Submitted ChargeAmount | 14864.6 |
| Total Drug Medicare AllowedAmount | 4684.16 |
| Total Drug Medicare PaymentAmount | 3619.97 |
| Total Drug Medicare Standardized Payment Amount | 3619.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 158 |
| Number Of Medical Services | 4863 |
| Number Of Medicare Beneficiaries With Medical Services | 3412 |
| Total Medical Submitted Charge Amount | 1467287.01 |
| Total Medical Medicare Allowed Amount | 407785.05 |
| Total Medical Medicare Payment Amount | 309567.66 |
| Total Medical Medicare Standardized Payment Amount | 317103.25 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 465 |
| Number Of Beneficiaries Age 65 to 74 | 1456 |
| Number Of Beneficiaries Age 75 to 84 | 1020 |
| Number Of Beneficiaries Age Greater 84 | 471 |
| Number Of Female Beneficiaries | 1902 |
| Number Of Male Beneficiaries | 1510 |
| Number Of Non Hispanic White Beneficiaries | 2629 |
| Number Of Black or African American Beneficiaries | 300 |
| Number Of AsianPacific Islander Beneficiaries | 56 |
| Number Of Hispanic Beneficiaries | 395 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2827 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 585 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7404 |