| National Provider Identifier [NPI]: | 1003080623 |
| Last Name Of The Provider | KLECKNER |
| First Name Of The Provider | KENNETH |
| 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 | 5501 OLD YORK RD |
| Street Address 2 Of The Provider | EINSTEIN MEDICAL CENTER - PHILADELPHIA |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191413018 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 1200 |
| Number Of Medicare Beneficiaries | 764 |
| Total Submitted Charge Amount | 834649 |
| Total Medicare Allowed Amount | 139673.08 |
| Total Medicare Payment Amount | 108355.7 |
| Total Medicare Standardized Payment Amount | 108050.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 1200 |
| Number Of Medicare Beneficiaries With Medical Services | 764 |
| Total Medical Submitted Charge Amount | 834649 |
| Total Medical Medicare Allowed Amount | 139673.08 |
| Total Medical Medicare Payment Amount | 108355.7 |
| Total Medical Medicare Standardized Payment Amount | 108050.11 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 148 |
| Number Of Beneficiaries Age 65 to 74 | 223 |
| Number Of Beneficiaries Age 75 to 84 | 239 |
| Number Of Beneficiaries Age Greater 84 | 154 |
| Number Of Female Beneficiaries | 461 |
| Number Of Male Beneficiaries | 303 |
| Number Of Non Hispanic White Beneficiaries | 645 |
| Number Of Black or African American Beneficiaries | 58 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 550 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 214 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 33 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 2.1115 |