| National Provider Identifier [NPI]: | 1396716940 |
| Last Name Of The Provider | KLEIN |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8780 W GOLF RD |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | NILES |
| Zip Code Of The Provider | 607145602 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 2133 |
| Number Of Medicare Beneficiaries | 650 |
| Total Submitted Charge Amount | 400813.59 |
| Total Medicare Allowed Amount | 239877.21 |
| Total Medicare Payment Amount | 184596.13 |
| Total Medicare Standardized Payment Amount | 172880.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 3645 |
| Total Drug Medicare AllowedAmount | 1867.73 |
| Total Drug Medicare PaymentAmount | 1830.39 |
| Total Drug Medicare Standardized Payment Amount | 1830.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 2098 |
| Number Of Medicare Beneficiaries With Medical Services | 650 |
| Total Medical Submitted Charge Amount | 397168.59 |
| Total Medical Medicare Allowed Amount | 238009.48 |
| Total Medical Medicare Payment Amount | 182765.74 |
| Total Medical Medicare Standardized Payment Amount | 171050.4 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 220 |
| Number Of Beneficiaries Age 75 to 84 | 231 |
| Number Of Beneficiaries Age Greater 84 | 138 |
| Number Of Female Beneficiaries | 383 |
| Number Of Male Beneficiaries | 267 |
| Number Of Non Hispanic White Beneficiaries | 568 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 35 |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 531 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 119 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 23 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 53 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.1525 |