| National Provider Identifier [NPI]: | 1366605974 |
| Last Name Of The Provider | KEIFER |
| First Name Of The Provider | CLINT |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | AUD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3780 KING RD |
| Street Address 2 Of The Provider | SUITE 2C |
| City Of The Provider | TOLEDO |
| Zip Code Of The Provider | 436171400 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Audiologist (billing independently) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 323 |
| Number Of Medicare Beneficiaries | 278 |
| Total Submitted Charge Amount | 28359 |
| Total Medicare Allowed Amount | 11036.33 |
| Total Medicare Payment Amount | 8386.86 |
| Total Medicare Standardized Payment Amount | 8688.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 323 |
| Number Of Medicare Beneficiaries With Medical Services | 278 |
| Total Medical Submitted Charge Amount | 28359 |
| Total Medical Medicare Allowed Amount | 11036.33 |
| Total Medical Medicare Payment Amount | 8386.86 |
| Total Medical Medicare Standardized Payment Amount | 8688.21 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 64 |
| Number Of Beneficiaries Age 75 to 84 | 65 |
| Number Of Beneficiaries Age Greater 84 | 113 |
| Number Of Female Beneficiaries | 184 |
| Number Of Male Beneficiaries | 94 |
| Number Of Non Hispanic White Beneficiaries | 218 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 65 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 213 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 65 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 52 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 25 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.3101 |