National Provider Identifier [NPI]: |
1679510366 |
Last Name Of The Provider |
KLEIN |
First Name Of The Provider |
JONATHAN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
20000 HARVARD AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
WARRENSVILLE HEIGHTS |
Zip Code Of The Provider |
441226805 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
471 |
Number Of Medicare Beneficiaries |
426 |
Total Submitted Charge Amount |
428285 |
Total Medicare Allowed Amount |
68423 |
Total Medicare Payment Amount |
52720.75 |
Total Medicare Standardized Payment Amount |
53028.1 |
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 |
13 |
Number Of Medical Services |
471 |
Number Of Medicare Beneficiaries With Medical Services |
426 |
Total Medical Submitted Charge Amount |
428285 |
Total Medical Medicare Allowed Amount |
68423 |
Total Medical Medicare Payment Amount |
52720.75 |
Total Medical Medicare Standardized Payment Amount |
53028.1 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
157 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
86 |
Number Of Beneficiaries Age Greater 84 |
65 |
Number Of Female Beneficiaries |
253 |
Number Of Male Beneficiaries |
173 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
366 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
172 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
254 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
22 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
20 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.9222 |