| National Provider Identifier [NPI]: | 1528020195 |
| Last Name Of The Provider | KLEIN |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1709 S ROCK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 672075150 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 129 |
| Number Of Services | 6273 |
| Number Of Medicare Beneficiaries | 576 |
| Total Submitted Charge Amount | 574927 |
| Total Medicare Allowed Amount | 188608.25 |
| Total Medicare Payment Amount | 137942.63 |
| Total Medicare Standardized Payment Amount | 149945.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 19 |
| Number Of Drug Services | 368 |
| Number Of Medicare Beneficiaries With Drug Services | 141 |
| Total Drug Submitted ChargeAmount | 13096 |
| Total Drug Medicare AllowedAmount | 4229.03 |
| Total Drug Medicare PaymentAmount | 3594.82 |
| Total Drug Medicare Standardized Payment Amount | 3594.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 110 |
| Number Of Medical Services | 5905 |
| Number Of Medicare Beneficiaries With Medical Services | 576 |
| Total Medical Submitted Charge Amount | 561831 |
| Total Medical Medicare Allowed Amount | 184379.22 |
| Total Medical Medicare Payment Amount | 134347.81 |
| Total Medical Medicare Standardized Payment Amount | 146351.06 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 272 |
| Number Of Beneficiaries Age 75 to 84 | 163 |
| Number Of Beneficiaries Age Greater 84 | 62 |
| Number Of Female Beneficiaries | 301 |
| Number Of Male Beneficiaries | 275 |
| Number Of Non Hispanic White Beneficiaries | 533 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 536 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9219 |