| National Provider Identifier [NPI]: | 1124105259 |
| Last Name Of The Provider | KLUG |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4600 N HABANA AVE |
| Street Address 2 Of The Provider | STE 27 |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336147112 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 5 |
| Number Of Services | 639 |
| Number Of Medicare Beneficiaries | 91 |
| Total Submitted Charge Amount | 104612 |
| Total Medicare Allowed Amount | 45340.8 |
| Total Medicare Payment Amount | 35134.8 |
| Total Medicare Standardized Payment Amount | 42216.22 |
| 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 | 5 |
| Number Of Medical Services | 639 |
| Number Of Medicare Beneficiaries With Medical Services | 91 |
| Total Medical Submitted Charge Amount | 104612 |
| Total Medical Medicare Allowed Amount | 45340.8 |
| Total Medical Medicare Payment Amount | 35134.8 |
| Total Medical Medicare Standardized Payment Amount | 42216.22 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | 27 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 70 |
| Number Of Male Beneficiaries | 21 |
| Number Of Non Hispanic White Beneficiaries | 53 |
| Number Of Black or African American Beneficiaries | |
| 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 | 46 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 45 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 63 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 58 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 23 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 18 |
| Percent Of With Stroke | 23 |
| Average HCC Risk Score Of Beneficiaries | 2.7874 |