| National Provider Identifier [NPI]: | 1336137058 |
| Last Name Of The Provider | KLOTH |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 109 NEWTOWN RD |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | DANBURY |
| Zip Code Of The Provider | 068104120 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 5716 |
| Number Of Medicare Beneficiaries | 407 |
| Total Submitted Charge Amount | 1542854.16 |
| Total Medicare Allowed Amount | 461808.91 |
| Total Medicare Payment Amount | 340527.8 |
| Total Medicare Standardized Payment Amount | 293444.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 1900 |
| Number Of Medicare Beneficiaries With Drug Services | 261 |
| Total Drug Submitted ChargeAmount | 62375 |
| Total Drug Medicare AllowedAmount | 5680.04 |
| Total Drug Medicare PaymentAmount | 2031.98 |
| Total Drug Medicare Standardized Payment Amount | 2031.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 3816 |
| Number Of Medicare Beneficiaries With Medical Services | 407 |
| Total Medical Submitted Charge Amount | 1480479.16 |
| Total Medical Medicare Allowed Amount | 456128.87 |
| Total Medical Medicare Payment Amount | 338495.82 |
| Total Medical Medicare Standardized Payment Amount | 291412.39 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 155 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 205 |
| Number Of Male Beneficiaries | 202 |
| Number Of Non Hispanic White Beneficiaries | 366 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 300 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 107 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.331 |