| National Provider Identifier [NPI]: | 1770545691 |
| Last Name Of The Provider | KLEIN |
| First Name Of The Provider | TRACY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1709 S ROCK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 672075150 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 103 |
| Number Of Services | 4753.5 |
| Number Of Medicare Beneficiaries | 414 |
| Total Submitted Charge Amount | 336521 |
| Total Medicare Allowed Amount | 104939.78 |
| Total Medicare Payment Amount | 78501.29 |
| Total Medicare Standardized Payment Amount | 84182.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 658.5 |
| Number Of Medicare Beneficiaries With Drug Services | 126 |
| Total Drug Submitted ChargeAmount | 26872 |
| Total Drug Medicare AllowedAmount | 6283.57 |
| Total Drug Medicare PaymentAmount | 5114.39 |
| Total Drug Medicare Standardized Payment Amount | 5114.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 4095 |
| Number Of Medicare Beneficiaries With Medical Services | 414 |
| Total Medical Submitted Charge Amount | 309649 |
| Total Medical Medicare Allowed Amount | 98656.21 |
| Total Medical Medicare Payment Amount | 73386.9 |
| Total Medical Medicare Standardized Payment Amount | 79067.65 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 186 |
| Number Of Beneficiaries Age 75 to 84 | 122 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 222 |
| Number Of Male Beneficiaries | 192 |
| Number Of Non Hispanic White Beneficiaries | 379 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 374 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0877 |