National Provider Identifier [NPI]: |
1386630713 |
Last Name Of The Provider |
KLEIMAN |
First Name Of The Provider |
JEFFREY |
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 |
1 PEARL ST |
Street Address 2 Of The Provider |
STE 1500 |
City Of The Provider |
BROCKTON |
Zip Code Of The Provider |
023012864 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
41 |
Number Of Services |
957 |
Number Of Medicare Beneficiaries |
120 |
Total Submitted Charge Amount |
152048.12 |
Total Medicare Allowed Amount |
66750.19 |
Total Medicare Payment Amount |
49098.1 |
Total Medicare Standardized Payment Amount |
46333.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
61 |
Number Of Medicare Beneficiaries With Drug Services |
42 |
Total Drug Submitted ChargeAmount |
1706.12 |
Total Drug Medicare AllowedAmount |
849.7 |
Total Drug Medicare PaymentAmount |
827 |
Total Drug Medicare Standardized Payment Amount |
827 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
896 |
Number Of Medicare Beneficiaries With Medical Services |
120 |
Total Medical Submitted Charge Amount |
150342 |
Total Medical Medicare Allowed Amount |
65900.49 |
Total Medical Medicare Payment Amount |
48271.1 |
Total Medical Medicare Standardized Payment Amount |
45506.61 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
54 |
Number Of Beneficiaries Age 75 to 84 |
23 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
58 |
Number Of Male Beneficiaries |
62 |
Number Of Non Hispanic White Beneficiaries |
98 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
93 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
27 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
28 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9154 |