| National Provider Identifier [NPI]: | 1790834737 |
| Last Name Of The Provider | KLEIN |
| First Name Of The Provider | MICHAEL |
| 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 | 2 SAINT ANTHONYS WAY |
| Street Address 2 Of The Provider | SUITE 205 |
| City Of The Provider | ALTON |
| Zip Code Of The Provider | 620024569 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 4448 |
| Number Of Medicare Beneficiaries | 690 |
| Total Submitted Charge Amount | 311848 |
| Total Medicare Allowed Amount | 221848.85 |
| Total Medicare Payment Amount | 145697.7 |
| Total Medicare Standardized Payment Amount | 147510.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 332 |
| Number Of Medicare Beneficiaries With Drug Services | 262 |
| Total Drug Submitted ChargeAmount | 14463 |
| Total Drug Medicare AllowedAmount | 9906.9 |
| Total Drug Medicare PaymentAmount | 9401.06 |
| Total Drug Medicare Standardized Payment Amount | 9401.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 4116 |
| Number Of Medicare Beneficiaries With Medical Services | 690 |
| Total Medical Submitted Charge Amount | 297385 |
| Total Medical Medicare Allowed Amount | 211941.95 |
| Total Medical Medicare Payment Amount | 136296.64 |
| Total Medical Medicare Standardized Payment Amount | 138109.45 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 114 |
| Number Of Beneficiaries Age 65 to 74 | 286 |
| Number Of Beneficiaries Age 75 to 84 | 181 |
| Number Of Beneficiaries Age Greater 84 | 109 |
| Number Of Female Beneficiaries | 350 |
| Number Of Male Beneficiaries | 340 |
| Number Of Non Hispanic White Beneficiaries | 649 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 588 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 102 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0326 |