National Provider Identifier [NPI]: |
1396731642 |
Last Name Of The Provider |
KLUFAS |
First Name Of The Provider |
ADRIAN |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3715 MAIN ST |
Street Address 2 Of The Provider |
STE 203 |
City Of The Provider |
BRIDGEPORT |
Zip Code Of The Provider |
066063611 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
3207 |
Number Of Medicare Beneficiaries |
332 |
Total Submitted Charge Amount |
290345 |
Total Medicare Allowed Amount |
228585.46 |
Total Medicare Payment Amount |
167933.03 |
Total Medicare Standardized Payment Amount |
160878.86 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
102 |
Number Of Medicare Beneficiaries With Drug Services |
87 |
Total Drug Submitted ChargeAmount |
2510 |
Total Drug Medicare AllowedAmount |
1196.31 |
Total Drug Medicare PaymentAmount |
1164.72 |
Total Drug Medicare Standardized Payment Amount |
1164.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
3105 |
Number Of Medicare Beneficiaries With Medical Services |
332 |
Total Medical Submitted Charge Amount |
287835 |
Total Medical Medicare Allowed Amount |
227389.15 |
Total Medical Medicare Payment Amount |
166768.31 |
Total Medical Medicare Standardized Payment Amount |
159714.14 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
161 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
187 |
Number Of Male Beneficiaries |
145 |
Number Of Non Hispanic White Beneficiaries |
101 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
154 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
37 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
295 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
37 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.9111 |