| National Provider Identifier [NPI]: | 1578562088 |
| Last Name Of The Provider | KLEIN |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3525 ENSIGN RD NE |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | OLYMPIA |
| Zip Code Of The Provider | 985065065 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 181 |
| Number Of Services | 4597 |
| Number Of Medicare Beneficiaries | 2473 |
| Total Submitted Charge Amount | 739578 |
| Total Medicare Allowed Amount | 126896.27 |
| Total Medicare Payment Amount | 101058.91 |
| Total Medicare Standardized Payment Amount | 102998.84 |
| 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 | 181 |
| Number Of Medical Services | 4597 |
| Number Of Medicare Beneficiaries With Medical Services | 2473 |
| Total Medical Submitted Charge Amount | 739578 |
| Total Medical Medicare Allowed Amount | 126896.27 |
| Total Medical Medicare Payment Amount | 101058.91 |
| Total Medical Medicare Standardized Payment Amount | 102998.84 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 353 |
| Number Of Beneficiaries Age 65 to 74 | 1199 |
| Number Of Beneficiaries Age 75 to 84 | 670 |
| Number Of Beneficiaries Age Greater 84 | 251 |
| Number Of Female Beneficiaries | 1572 |
| Number Of Male Beneficiaries | 901 |
| Number Of Non Hispanic White Beneficiaries | 2283 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | 61 |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | 40 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2094 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 379 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0989 |