| National Provider Identifier [NPI]: | 1962494831 |
| Last Name Of The Provider | KLIM |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 143 GARDEN HOMES DRIVE |
| Street Address 2 Of The Provider | NORTHEASTER WASHINGTON MEDICAL GROUP |
| City Of The Provider | COLVILLE |
| Zip Code Of The Provider | 991140000 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 3429 |
| Number Of Medicare Beneficiaries | 458 |
| Total Submitted Charge Amount | 365566.81 |
| Total Medicare Allowed Amount | 156357.13 |
| Total Medicare Payment Amount | 117757.15 |
| Total Medicare Standardized Payment Amount | 120020.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 1679 |
| Number Of Medicare Beneficiaries With Drug Services | 109 |
| Total Drug Submitted ChargeAmount | 11323 |
| Total Drug Medicare AllowedAmount | 6927.54 |
| Total Drug Medicare PaymentAmount | 6380.27 |
| Total Drug Medicare Standardized Payment Amount | 6380.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 1750 |
| Number Of Medicare Beneficiaries With Medical Services | 458 |
| Total Medical Submitted Charge Amount | 354243.81 |
| Total Medical Medicare Allowed Amount | 149429.59 |
| Total Medical Medicare Payment Amount | 111376.88 |
| Total Medical Medicare Standardized Payment Amount | 113640.33 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 163 |
| Number Of Beneficiaries Age 75 to 84 | 167 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 220 |
| Number Of Male Beneficiaries | 238 |
| Number Of Non Hispanic White Beneficiaries | 432 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 346 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 112 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3941 |