| National Provider Identifier [NPI]: | 1558306571 |
| Last Name Of The Provider | KLEIN |
| First Name Of The Provider | WENDY |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 51 N 39TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191042640 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 3456 |
| Number Of Medicare Beneficiaries | 1929 |
| Total Submitted Charge Amount | 167599 |
| Total Medicare Allowed Amount | 55689.4 |
| Total Medicare Payment Amount | 41040.28 |
| Total Medicare Standardized Payment Amount | 39040.4 |
| 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 | 79 |
| Number Of Medical Services | 3456 |
| Number Of Medicare Beneficiaries With Medical Services | 1929 |
| Total Medical Submitted Charge Amount | 167599 |
| Total Medical Medicare Allowed Amount | 55689.4 |
| Total Medical Medicare Payment Amount | 41040.28 |
| Total Medical Medicare Standardized Payment Amount | 39040.4 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 504 |
| Number Of Beneficiaries Age 65 to 74 | 740 |
| Number Of Beneficiaries Age 75 to 84 | 474 |
| Number Of Beneficiaries Age Greater 84 | 211 |
| Number Of Female Beneficiaries | 1037 |
| Number Of Male Beneficiaries | 892 |
| Number Of Non Hispanic White Beneficiaries | 954 |
| Number Of Black or African American Beneficiaries | 877 |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1280 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 649 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9697 |