| National Provider Identifier [NPI]: | 1649217688 |
| Last Name Of The Provider | KLEIMEYER |
| First Name Of The Provider | TED |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4983 DELHI AVE |
| Street Address 2 Of The Provider | SUITE 6 |
| City Of The Provider | CINCINNATI |
| Zip Code Of The Provider | 452385380 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 167 |
| Number Of Services | 5566 |
| Number Of Medicare Beneficiaries | 3066 |
| Total Submitted Charge Amount | 456799 |
| Total Medicare Allowed Amount | 141008.07 |
| Total Medicare Payment Amount | 109079.32 |
| Total Medicare Standardized Payment Amount | 113254.43 |
| 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 | 167 |
| Number Of Medical Services | 5566 |
| Number Of Medicare Beneficiaries With Medical Services | 3066 |
| Total Medical Submitted Charge Amount | 456799 |
| Total Medical Medicare Allowed Amount | 141008.07 |
| Total Medical Medicare Payment Amount | 109079.32 |
| Total Medical Medicare Standardized Payment Amount | 113254.43 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 641 |
| Number Of Beneficiaries Age 65 to 74 | 932 |
| Number Of Beneficiaries Age 75 to 84 | 869 |
| Number Of Beneficiaries Age Greater 84 | 624 |
| Number Of Female Beneficiaries | 1945 |
| Number Of Male Beneficiaries | 1121 |
| Number Of Non Hispanic White Beneficiaries | 2637 |
| Number Of Black or African American Beneficiaries | 359 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2251 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 815 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6563 |