| National Provider Identifier [NPI]: | 1992781777 |
| Last Name Of The Provider | KLEIN |
| First Name Of The Provider | FRED |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 325 N COMMERCIAL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEENAH |
| Zip Code Of The Provider | 549562665 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 167 |
| Number Of Services | 2673 |
| Number Of Medicare Beneficiaries | 1832 |
| Total Submitted Charge Amount | 523686 |
| Total Medicare Allowed Amount | 68074.4 |
| Total Medicare Payment Amount | 52846.35 |
| Total Medicare Standardized Payment Amount | 55269.14 |
| 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 | 167 |
| Number Of Medical Services | 2673 |
| Number Of Medicare Beneficiaries With Medical Services | 1832 |
| Total Medical Submitted Charge Amount | 523686 |
| Total Medical Medicare Allowed Amount | 68074.4 |
| Total Medical Medicare Payment Amount | 52846.35 |
| Total Medical Medicare Standardized Payment Amount | 55269.14 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 334 |
| Number Of Beneficiaries Age 65 to 74 | 663 |
| Number Of Beneficiaries Age 75 to 84 | 527 |
| Number Of Beneficiaries Age Greater 84 | 308 |
| Number Of Female Beneficiaries | 1207 |
| Number Of Male Beneficiaries | 625 |
| Number Of Non Hispanic White Beneficiaries | 1778 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1402 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 430 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3704 |