| National Provider Identifier [NPI]: | 1114975588 |
| Last Name Of The Provider | KLIEGER |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1524 MCHENRY AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MODESTO |
| Zip Code Of The Provider | 953504500 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 149 |
| Number Of Services | 4782 |
| Number Of Medicare Beneficiaries | 2027 |
| Total Submitted Charge Amount | 910683.36 |
| Total Medicare Allowed Amount | 152968.43 |
| Total Medicare Payment Amount | 114118.73 |
| Total Medicare Standardized Payment Amount | 110970.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1632 |
| Number Of Medicare Beneficiaries With Drug Services | 59 |
| Total Drug Submitted ChargeAmount | 2613 |
| Total Drug Medicare AllowedAmount | 376.37 |
| Total Drug Medicare PaymentAmount | 250.52 |
| Total Drug Medicare Standardized Payment Amount | 250.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 146 |
| Number Of Medical Services | 3150 |
| Number Of Medicare Beneficiaries With Medical Services | 2027 |
| Total Medical Submitted Charge Amount | 908070.36 |
| Total Medical Medicare Allowed Amount | 152592.06 |
| Total Medical Medicare Payment Amount | 113868.21 |
| Total Medical Medicare Standardized Payment Amount | 110719.7 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 449 |
| Number Of Beneficiaries Age 65 to 74 | 719 |
| Number Of Beneficiaries Age 75 to 84 | 546 |
| Number Of Beneficiaries Age Greater 84 | 313 |
| Number Of Female Beneficiaries | 1105 |
| Number Of Male Beneficiaries | 922 |
| Number Of Non Hispanic White Beneficiaries | 1383 |
| Number Of Black or African American Beneficiaries | 65 |
| Number Of AsianPacific Islander Beneficiaries | 90 |
| Number Of Hispanic Beneficiaries | 450 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 942 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1085 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.9227 |