| National Provider Identifier [NPI]: | 1407821283 |
| Last Name Of The Provider | KLAUSNER |
| First Name Of The Provider | TODD |
| 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 | 111 S GRANT AVE |
| Street Address 2 Of The Provider | 3RD FLOOR RADIOLOGY DEPT |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432154701 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 171 |
| Number Of Services | 8160 |
| Number Of Medicare Beneficiaries | 3343 |
| Total Submitted Charge Amount | 958659.06 |
| Total Medicare Allowed Amount | 370492.04 |
| Total Medicare Payment Amount | 286505.77 |
| Total Medicare Standardized Payment Amount | 300245.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1061 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 60955 |
| Total Drug Medicare AllowedAmount | 47957.38 |
| Total Drug Medicare PaymentAmount | 37604.02 |
| Total Drug Medicare Standardized Payment Amount | 37604.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 167 |
| Number Of Medical Services | 7099 |
| Number Of Medicare Beneficiaries With Medical Services | 3343 |
| Total Medical Submitted Charge Amount | 897704.06 |
| Total Medical Medicare Allowed Amount | 322534.66 |
| Total Medical Medicare Payment Amount | 248901.75 |
| Total Medical Medicare Standardized Payment Amount | 262641.91 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 944 |
| Number Of Beneficiaries Age 65 to 74 | 1222 |
| Number Of Beneficiaries Age 75 to 84 | 793 |
| Number Of Beneficiaries Age Greater 84 | 384 |
| Number Of Female Beneficiaries | 2146 |
| Number Of Male Beneficiaries | 1197 |
| Number Of Non Hispanic White Beneficiaries | 2807 |
| Number Of Black or African American Beneficiaries | 456 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2069 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1274 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7316 |