National Provider Identifier [NPI]: |
1407852551 |
Last Name Of The Provider |
KLAZURA |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2300 N ROCKTON AVE |
Street Address 2 Of The Provider |
STE 304 |
City Of The Provider |
ROCKFORD |
Zip Code Of The Provider |
611033619 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
156 |
Number Of Services |
1944 |
Number Of Medicare Beneficiaries |
570 |
Total Submitted Charge Amount |
880263.13 |
Total Medicare Allowed Amount |
314401.75 |
Total Medicare Payment Amount |
238067.55 |
Total Medicare Standardized Payment Amount |
245294.37 |
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 |
156 |
Number Of Medical Services |
1944 |
Number Of Medicare Beneficiaries With Medical Services |
570 |
Total Medical Submitted Charge Amount |
880263.13 |
Total Medical Medicare Allowed Amount |
314401.75 |
Total Medical Medicare Payment Amount |
238067.55 |
Total Medical Medicare Standardized Payment Amount |
245294.37 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
224 |
Number Of Beneficiaries Age 75 to 84 |
194 |
Number Of Beneficiaries Age Greater 84 |
88 |
Number Of Female Beneficiaries |
293 |
Number Of Male Beneficiaries |
277 |
Number Of Non Hispanic White Beneficiaries |
505 |
Number Of Black or African American Beneficiaries |
48 |
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 |
467 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.7919 |