National Provider Identifier [NPI]: |
1912929423 |
Last Name Of The Provider |
KLEIN |
First Name Of The Provider |
ADI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8811 VILLAGE DRIVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
78217 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
275 |
Number Of Medicare Beneficiaries |
248 |
Total Submitted Charge Amount |
94855 |
Total Medicare Allowed Amount |
44556.21 |
Total Medicare Payment Amount |
34511.54 |
Total Medicare Standardized Payment Amount |
36030.3 |
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 |
12 |
Number Of Medical Services |
275 |
Number Of Medicare Beneficiaries With Medical Services |
248 |
Total Medical Submitted Charge Amount |
94855 |
Total Medical Medicare Allowed Amount |
44556.21 |
Total Medical Medicare Payment Amount |
34511.54 |
Total Medical Medicare Standardized Payment Amount |
36030.3 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
67 |
Number Of Beneficiaries Age 65 to 74 |
74 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
107 |
Number Of Non Hispanic White Beneficiaries |
114 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
114 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
156 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
92 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
65 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
18 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.7222 |