| National Provider Identifier [NPI]: | 1740366046 |
| Last Name Of The Provider | KLEEFIELD |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 330 BROOKLINE AVE |
| Street Address 2 Of The Provider | CC472 |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 022155400 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 2116 |
| Number Of Medicare Beneficiaries | 1285 |
| Total Submitted Charge Amount | 479604 |
| Total Medicare Allowed Amount | 150654.94 |
| Total Medicare Payment Amount | 114930.02 |
| Total Medicare Standardized Payment Amount | 114114.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 247 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 2470 |
| Total Drug Medicare AllowedAmount | 486.97 |
| Total Drug Medicare PaymentAmount | 381.79 |
| Total Drug Medicare Standardized Payment Amount | 381.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 1869 |
| Number Of Medicare Beneficiaries With Medical Services | 1285 |
| Total Medical Submitted Charge Amount | 477134 |
| Total Medical Medicare Allowed Amount | 150167.97 |
| Total Medical Medicare Payment Amount | 114548.23 |
| Total Medical Medicare Standardized Payment Amount | 113733.2 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 256 |
| Number Of Beneficiaries Age 65 to 74 | 420 |
| Number Of Beneficiaries Age 75 to 84 | 343 |
| Number Of Beneficiaries Age Greater 84 | 266 |
| Number Of Female Beneficiaries | 769 |
| Number Of Male Beneficiaries | 516 |
| Number Of Non Hispanic White Beneficiaries | 1194 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 62 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 905 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 380 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.3225 |