| National Provider Identifier [NPI]: | 1780664367 |
| Last Name Of The Provider | KLOMBERS |
| First Name Of The Provider | LEE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3855 PENN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SINKING SPRING |
| Zip Code Of The Provider | 196081174 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 13137 |
| Number Of Medicare Beneficiaries | 696 |
| Total Submitted Charge Amount | 850628 |
| Total Medicare Allowed Amount | 336148.21 |
| Total Medicare Payment Amount | 253092.28 |
| Total Medicare Standardized Payment Amount | 247683.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 10704 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 114010 |
| Total Drug Medicare AllowedAmount | 58833.28 |
| Total Drug Medicare PaymentAmount | 45624.65 |
| Total Drug Medicare Standardized Payment Amount | 45624.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 2433 |
| Number Of Medicare Beneficiaries With Medical Services | 696 |
| Total Medical Submitted Charge Amount | 736618 |
| Total Medical Medicare Allowed Amount | 277314.93 |
| Total Medical Medicare Payment Amount | 207467.63 |
| Total Medical Medicare Standardized Payment Amount | 202058.93 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 95 |
| Number Of Beneficiaries Age 65 to 74 | 251 |
| Number Of Beneficiaries Age 75 to 84 | 242 |
| Number Of Beneficiaries Age Greater 84 | 108 |
| Number Of Female Beneficiaries | 393 |
| Number Of Male Beneficiaries | 303 |
| Number Of Non Hispanic White Beneficiaries | 659 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 619 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.3405 |