| National Provider Identifier [NPI]: | 1023013109 |
| Last Name Of The Provider | KLEIN |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D.,MPH, TM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2855 E MAGIC VIEW DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MERIDIAN |
| Zip Code Of The Provider | 836426245 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 112 |
| Number Of Services | 4351 |
| Number Of Medicare Beneficiaries | 544 |
| Total Submitted Charge Amount | 554233.75 |
| Total Medicare Allowed Amount | 193326.42 |
| Total Medicare Payment Amount | 147265.73 |
| Total Medicare Standardized Payment Amount | 158654.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 1633 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 32385 |
| Total Drug Medicare AllowedAmount | 22512.07 |
| Total Drug Medicare PaymentAmount | 17469.46 |
| Total Drug Medicare Standardized Payment Amount | 17469.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 103 |
| Number Of Medical Services | 2718 |
| Number Of Medicare Beneficiaries With Medical Services | 542 |
| Total Medical Submitted Charge Amount | 521848.75 |
| Total Medical Medicare Allowed Amount | 170814.35 |
| Total Medical Medicare Payment Amount | 129796.27 |
| Total Medical Medicare Standardized Payment Amount | 141184.76 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 240 |
| Number Of Beneficiaries Age 75 to 84 | 167 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 124 |
| Number Of Male Beneficiaries | 420 |
| Number Of Non Hispanic White Beneficiaries | 500 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 457 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1234 |