National Provider Identifier [NPI]: |
1437191475 |
Last Name Of The Provider |
KLINE |
First Name Of The Provider |
JASON |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2600 GLASGOW AVE |
Street Address 2 Of The Provider |
STE 107 |
City Of The Provider |
NEWARK |
Zip Code Of The Provider |
197024777 |
State Code Of The Provider |
DE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
67 |
Number Of Services |
1505 |
Number Of Medicare Beneficiaries |
432 |
Total Submitted Charge Amount |
172962.59 |
Total Medicare Allowed Amount |
110773.1 |
Total Medicare Payment Amount |
79969.54 |
Total Medicare Standardized Payment Amount |
79746.44 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
116 |
Number Of Medicare Beneficiaries With Drug Services |
29 |
Total Drug Submitted ChargeAmount |
2700 |
Total Drug Medicare AllowedAmount |
1569.93 |
Total Drug Medicare PaymentAmount |
1223.42 |
Total Drug Medicare Standardized Payment Amount |
1223.42 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
63 |
Number Of Medical Services |
1389 |
Number Of Medicare Beneficiaries With Medical Services |
432 |
Total Medical Submitted Charge Amount |
170262.59 |
Total Medical Medicare Allowed Amount |
109203.17 |
Total Medical Medicare Payment Amount |
78746.12 |
Total Medical Medicare Standardized Payment Amount |
78523.02 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
102 |
Number Of Beneficiaries Age 65 to 74 |
182 |
Number Of Beneficiaries Age 75 to 84 |
108 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
234 |
Number Of Male Beneficiaries |
198 |
Number Of Non Hispanic White Beneficiaries |
301 |
Number Of Black or African American Beneficiaries |
110 |
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 |
314 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
118 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6279 |