National Provider Identifier [NPI]: |
1629073945 |
Last Name Of The Provider |
KLEIN |
First Name Of The Provider |
IRA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
29 E 29TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BAYONNE |
Zip Code Of The Provider |
070024654 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
270 |
Number Of Medicare Beneficiaries |
235 |
Total Submitted Charge Amount |
298088 |
Total Medicare Allowed Amount |
45904.05 |
Total Medicare Payment Amount |
35769.74 |
Total Medicare Standardized Payment Amount |
33545.49 |
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 |
270 |
Number Of Medicare Beneficiaries With Medical Services |
235 |
Total Medical Submitted Charge Amount |
298088 |
Total Medical Medicare Allowed Amount |
45904.05 |
Total Medical Medicare Payment Amount |
35769.74 |
Total Medical Medicare Standardized Payment Amount |
33545.49 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
120 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
128 |
Number Of Male Beneficiaries |
107 |
Number Of Non Hispanic White Beneficiaries |
17 |
Number Of Black or African American Beneficiaries |
176 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
27 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
121 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
114 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
69 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
75 |
Percent Of With Hyperlipidemia |
51 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
72 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
8.6275 |