National Provider Identifier [NPI]: |
1023013158 |
Last Name Of The Provider |
KLINE |
First Name Of The Provider |
RONALD |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
630 N ALVERNON WAY |
Street Address 2 Of The Provider |
#180 |
City Of The Provider |
TUCSON |
Zip Code Of The Provider |
857111843 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Vascular Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
141 |
Number Of Services |
1391 |
Number Of Medicare Beneficiaries |
429 |
Total Submitted Charge Amount |
565821 |
Total Medicare Allowed Amount |
260662.29 |
Total Medicare Payment Amount |
196986.64 |
Total Medicare Standardized Payment Amount |
200082.67 |
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 |
141 |
Number Of Medical Services |
1391 |
Number Of Medicare Beneficiaries With Medical Services |
429 |
Total Medical Submitted Charge Amount |
565821 |
Total Medical Medicare Allowed Amount |
260662.29 |
Total Medical Medicare Payment Amount |
196986.64 |
Total Medical Medicare Standardized Payment Amount |
200082.67 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
28 |
Number Of Beneficiaries Age 65 to 74 |
158 |
Number Of Beneficiaries Age 75 to 84 |
167 |
Number Of Beneficiaries Age Greater 84 |
76 |
Number Of Female Beneficiaries |
218 |
Number Of Male Beneficiaries |
211 |
Number Of Non Hispanic White Beneficiaries |
383 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
391 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.7317 |