| National Provider Identifier [NPI]: | 1639145782 |
| Last Name Of The Provider | RUBAKOVIC |
| First Name Of The Provider | SVETLANA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 69844 HWY 111 SUITE K |
| Street Address 2 Of The Provider | |
| City Of The Provider | RANCHO MIRAGE |
| Zip Code Of The Provider | 92270 |
| 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 | 89 |
| Number Of Services | 8552 |
| Number Of Medicare Beneficiaries | 1100 |
| Total Submitted Charge Amount | 710728.51 |
| Total Medicare Allowed Amount | 599024.31 |
| Total Medicare Payment Amount | 466984.77 |
| Total Medicare Standardized Payment Amount | 465102.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 483 |
| Number Of Medicare Beneficiaries With Drug Services | 251 |
| Total Drug Submitted ChargeAmount | 126562.17 |
| Total Drug Medicare AllowedAmount | 111474.69 |
| Total Drug Medicare PaymentAmount | 87378.16 |
| Total Drug Medicare Standardized Payment Amount | 87378.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 8069 |
| Number Of Medicare Beneficiaries With Medical Services | 1100 |
| Total Medical Submitted Charge Amount | 584166.34 |
| Total Medical Medicare Allowed Amount | 487549.62 |
| Total Medical Medicare Payment Amount | 379606.61 |
| Total Medical Medicare Standardized Payment Amount | 377724.02 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 540 |
| Number Of Beneficiaries Age 75 to 84 | 403 |
| Number Of Beneficiaries Age Greater 84 | 145 |
| Number Of Female Beneficiaries | 682 |
| Number Of Male Beneficiaries | 418 |
| Number Of Non Hispanic White Beneficiaries | 1057 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1084 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9212 |