| National Provider Identifier [NPI]: | 1912013145 |
| Last Name Of The Provider | SCHOMBERG-KLAISS |
| First Name Of The Provider | KITTURAH |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2731 MLK JR BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUSCALOOSA |
| Zip Code Of The Provider | 35403 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 3588 |
| Number Of Medicare Beneficiaries | 493 |
| Total Submitted Charge Amount | 137836.92 |
| Total Medicare Allowed Amount | 84914.66 |
| Total Medicare Payment Amount | 58283.99 |
| Total Medicare Standardized Payment Amount | 62680.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 19 |
| Number Of Drug Services | 1350 |
| Number Of Medicare Beneficiaries With Drug Services | 280 |
| Total Drug Submitted ChargeAmount | 16526.4 |
| Total Drug Medicare AllowedAmount | 4948.22 |
| Total Drug Medicare PaymentAmount | 3628.1 |
| Total Drug Medicare Standardized Payment Amount | 3628.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 2238 |
| Number Of Medicare Beneficiaries With Medical Services | 493 |
| Total Medical Submitted Charge Amount | 121310.52 |
| Total Medical Medicare Allowed Amount | 79966.44 |
| Total Medical Medicare Payment Amount | 54655.89 |
| Total Medical Medicare Standardized Payment Amount | 59052.66 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 179 |
| Number Of Beneficiaries Age 65 to 74 | 211 |
| Number Of Beneficiaries Age 75 to 84 | 78 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 317 |
| Number Of Male Beneficiaries | 176 |
| Number Of Non Hispanic White Beneficiaries | 351 |
| Number Of Black or African American Beneficiaries | |
| 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 | 383 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 110 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9813 |