National Provider Identifier [NPI]: |
1730185430 |
Last Name Of The Provider |
KLAG |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3805 E BELL RD |
Street Address 2 Of The Provider |
SUITE 3100 |
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
85032 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
71 |
Number Of Services |
4568 |
Number Of Medicare Beneficiaries |
1140 |
Total Submitted Charge Amount |
1117600 |
Total Medicare Allowed Amount |
538765.55 |
Total Medicare Payment Amount |
397235.19 |
Total Medicare Standardized Payment Amount |
404011.57 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
341 |
Number Of Medicare Beneficiaries With Drug Services |
87 |
Total Drug Submitted ChargeAmount |
40375 |
Total Drug Medicare AllowedAmount |
17816.14 |
Total Drug Medicare PaymentAmount |
13707.53 |
Total Drug Medicare Standardized Payment Amount |
13707.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
67 |
Number Of Medical Services |
4227 |
Number Of Medicare Beneficiaries With Medical Services |
1140 |
Total Medical Submitted Charge Amount |
1077225 |
Total Medical Medicare Allowed Amount |
520949.41 |
Total Medical Medicare Payment Amount |
383527.66 |
Total Medical Medicare Standardized Payment Amount |
390304.04 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
557 |
Number Of Beneficiaries Age 75 to 84 |
369 |
Number Of Beneficiaries Age Greater 84 |
165 |
Number Of Female Beneficiaries |
511 |
Number Of Male Beneficiaries |
629 |
Number Of Non Hispanic White Beneficiaries |
1066 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
11 |
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
20 |
Number Of Beneficiaries With Medicare Only Entitlement |
1074 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
66 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3439 |