National Provider Identifier [NPI]: |
1558354365 |
Last Name Of The Provider |
KLEIN |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
32901 23 MILE RD |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
CHESTERFIELD |
Zip Code Of The Provider |
480474063 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
64 |
Number Of Services |
2205 |
Number Of Medicare Beneficiaries |
238 |
Total Submitted Charge Amount |
120570 |
Total Medicare Allowed Amount |
93395.37 |
Total Medicare Payment Amount |
68641.22 |
Total Medicare Standardized Payment Amount |
67901.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
256 |
Number Of Medicare Beneficiaries With Drug Services |
104 |
Total Drug Submitted ChargeAmount |
5269 |
Total Drug Medicare AllowedAmount |
4178.99 |
Total Drug Medicare PaymentAmount |
3630.39 |
Total Drug Medicare Standardized Payment Amount |
3630.39 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
54 |
Number Of Medical Services |
1949 |
Number Of Medicare Beneficiaries With Medical Services |
238 |
Total Medical Submitted Charge Amount |
115301 |
Total Medical Medicare Allowed Amount |
89216.38 |
Total Medical Medicare Payment Amount |
65010.83 |
Total Medical Medicare Standardized Payment Amount |
64271.1 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
117 |
Number Of Beneficiaries Age 75 to 84 |
68 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
113 |
Number Of Male Beneficiaries |
125 |
Number Of Non Hispanic White Beneficiaries |
223 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
218 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2091 |