National Provider Identifier [NPI]: |
1437337839 |
Last Name Of The Provider |
KLEINBERG |
First Name Of The Provider |
JEFFREY |
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 |
80 SEYMOUR ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
HARTFORD |
Zip Code Of The Provider |
061028000 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
712 |
Number Of Medicare Beneficiaries |
654 |
Total Submitted Charge Amount |
404946 |
Total Medicare Allowed Amount |
113533.5 |
Total Medicare Payment Amount |
87700.53 |
Total Medicare Standardized Payment Amount |
83332.27 |
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 |
19 |
Number Of Medical Services |
712 |
Number Of Medicare Beneficiaries With Medical Services |
654 |
Total Medical Submitted Charge Amount |
404946 |
Total Medical Medicare Allowed Amount |
113533.5 |
Total Medical Medicare Payment Amount |
87700.53 |
Total Medical Medicare Standardized Payment Amount |
83332.27 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
173 |
Number Of Beneficiaries Age 65 to 74 |
138 |
Number Of Beneficiaries Age 75 to 84 |
160 |
Number Of Beneficiaries Age Greater 84 |
183 |
Number Of Female Beneficiaries |
361 |
Number Of Male Beneficiaries |
293 |
Number Of Non Hispanic White Beneficiaries |
478 |
Number Of Black or African American Beneficiaries |
58 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
104 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
351 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
303 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.2742 |