| National Provider Identifier [NPI]: | 1114980315 |
| Last Name Of The Provider | KLAVANS |
| First Name Of The Provider | MITCHELL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 430 MORTON PLANT ST |
| Street Address 2 Of The Provider | SUITE 206 |
| City Of The Provider | CLEARWATER |
| Zip Code Of The Provider | 33756 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 115 |
| Number Of Services | 10546 |
| Number Of Medicare Beneficiaries | 1560 |
| Total Submitted Charge Amount | 1623961.9 |
| Total Medicare Allowed Amount | 807681.71 |
| Total Medicare Payment Amount | 609459.28 |
| Total Medicare Standardized Payment Amount | 612826.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 1495 |
| Number Of Medicare Beneficiaries With Drug Services | 180 |
| Total Drug Submitted ChargeAmount | 319709.9 |
| Total Drug Medicare AllowedAmount | 182653.7 |
| Total Drug Medicare PaymentAmount | 142348.32 |
| Total Drug Medicare Standardized Payment Amount | 142348.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 104 |
| Number Of Medical Services | 9051 |
| Number Of Medicare Beneficiaries With Medical Services | 1560 |
| Total Medical Submitted Charge Amount | 1304252 |
| Total Medical Medicare Allowed Amount | 625028.01 |
| Total Medical Medicare Payment Amount | 467110.96 |
| Total Medical Medicare Standardized Payment Amount | 470477.96 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 80 |
| Number Of Beneficiaries Age 65 to 74 | 629 |
| Number Of Beneficiaries Age 75 to 84 | 555 |
| Number Of Beneficiaries Age Greater 84 | 296 |
| Number Of Female Beneficiaries | 371 |
| Number Of Male Beneficiaries | 1189 |
| Number Of Non Hispanic White Beneficiaries | 1487 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1478 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 82 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 32 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2792 |