| National Provider Identifier [NPI]: | 1376613208 |
| Last Name Of The Provider | KLEIN |
| First Name Of The Provider | HELEN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | NURSE PRACTITIONER |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3524 TONGASS AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | KETCHIKAN |
| Zip Code Of The Provider | 999015635 |
| State Code Of The Provider | AK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 853 |
| Number Of Medicare Beneficiaries | 244 |
| Total Submitted Charge Amount | 52515.43 |
| Total Medicare Allowed Amount | 47205.03 |
| Total Medicare Payment Amount | 30961.71 |
| Total Medicare Standardized Payment Amount | 33389.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 92 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 4990.98 |
| Total Drug Medicare AllowedAmount | 3447.85 |
| Total Drug Medicare PaymentAmount | 3080.44 |
| Total Drug Medicare Standardized Payment Amount | 3080.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 761 |
| Number Of Medicare Beneficiaries With Medical Services | 244 |
| Total Medical Submitted Charge Amount | 47524.45 |
| Total Medical Medicare Allowed Amount | 43757.18 |
| Total Medical Medicare Payment Amount | 27881.27 |
| Total Medical Medicare Standardized Payment Amount | 30309.15 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 138 |
| Number Of Beneficiaries Age 75 to 84 | 64 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 133 |
| Number Of Male Beneficiaries | 111 |
| Number Of Non Hispanic White Beneficiaries | 214 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 16 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 214 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9225 |