| National Provider Identifier [NPI]: | 1720083744 |
| Last Name Of The Provider | RUBINSTEIN |
| First Name Of The Provider | GENNADY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3959 LAUREL CANYON BLVD |
| Street Address 2 Of The Provider | SUITE F |
| City Of The Provider | STUDIO CITY |
| Zip Code Of The Provider | 916044921 |
| 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 | 79 |
| Number Of Services | 7148 |
| Number Of Medicare Beneficiaries | 946 |
| Total Submitted Charge Amount | 1618681.82 |
| Total Medicare Allowed Amount | 932182.83 |
| Total Medicare Payment Amount | 720332.74 |
| Total Medicare Standardized Payment Amount | 662901.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 392 |
| Number Of Medicare Beneficiaries With Drug Services | 113 |
| Total Drug Submitted ChargeAmount | 23685 |
| Total Drug Medicare AllowedAmount | 14908.39 |
| Total Drug Medicare PaymentAmount | 11686.67 |
| Total Drug Medicare Standardized Payment Amount | 11686.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 6756 |
| Number Of Medicare Beneficiaries With Medical Services | 946 |
| Total Medical Submitted Charge Amount | 1594996.82 |
| Total Medical Medicare Allowed Amount | 917274.44 |
| Total Medical Medicare Payment Amount | 708646.07 |
| Total Medical Medicare Standardized Payment Amount | 651215.09 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 385 |
| Number Of Beneficiaries Age 75 to 84 | 364 |
| Number Of Beneficiaries Age Greater 84 | 130 |
| Number Of Female Beneficiaries | 521 |
| Number Of Male Beneficiaries | 425 |
| Number Of Non Hispanic White Beneficiaries | 866 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 42 |
| Number Of Beneficiaries With Medicare Only Entitlement | 432 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 514 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2613 |