| National Provider Identifier [NPI]: | 1306882352 |
| Last Name Of The Provider | RUBESIN |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3400 SPRUCE ST |
| Street Address 2 Of The Provider | GROUND FLOOR DULLES |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 19104 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 2199 |
| Number Of Medicare Beneficiaries | 1587 |
| Total Submitted Charge Amount | 123627 |
| Total Medicare Allowed Amount | 40996.4 |
| Total Medicare Payment Amount | 31303.18 |
| Total Medicare Standardized Payment Amount | 29895.16 |
| 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 | 41 |
| Number Of Medical Services | 2199 |
| Number Of Medicare Beneficiaries With Medical Services | 1587 |
| Total Medical Submitted Charge Amount | 123627 |
| Total Medical Medicare Allowed Amount | 40996.4 |
| Total Medical Medicare Payment Amount | 31303.18 |
| Total Medical Medicare Standardized Payment Amount | 29895.16 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 404 |
| Number Of Beneficiaries Age 65 to 74 | 674 |
| Number Of Beneficiaries Age 75 to 84 | 385 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 776 |
| Number Of Male Beneficiaries | 811 |
| Number Of Non Hispanic White Beneficiaries | 1109 |
| Number Of Black or African American Beneficiaries | 384 |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1195 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 392 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.3683 |