National Provider Identifier [NPI]: |
1376633313 |
Last Name Of The Provider |
KLAYMAN |
First Name Of The Provider |
KEVIN |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 ROE AVE |
Street Address 2 Of The Provider |
ARNOT OGDEN MEDICAL CENTER |
City Of The Provider |
ELMIRA |
Zip Code Of The Provider |
14905 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
161 |
Number Of Medicare Beneficiaries |
110 |
Total Submitted Charge Amount |
37691.68 |
Total Medicare Allowed Amount |
6086.36 |
Total Medicare Payment Amount |
4771.97 |
Total Medicare Standardized Payment Amount |
4422.53 |
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 |
52 |
Number Of Medical Services |
161 |
Number Of Medicare Beneficiaries With Medical Services |
110 |
Total Medical Submitted Charge Amount |
37691.68 |
Total Medical Medicare Allowed Amount |
6086.36 |
Total Medical Medicare Payment Amount |
4771.97 |
Total Medical Medicare Standardized Payment Amount |
4422.53 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
60 |
Number Of Male Beneficiaries |
50 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
95 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
12 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
98 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
60 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
55 |
Percent Of With Depression |
61 |
Percent Of With Diabetes |
67 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
72 |
Percent Of With Schizophrenia Other PsychoticDisorders |
30 |
Percent Of With Stroke |
21 |
Average HCC Risk Score Of Beneficiaries |
2.3463 |