| National Provider Identifier [NPI]: | 1982623229 |
| Last Name Of The Provider | CLINE |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 945 N 12TH ST |
| Street Address 2 Of The Provider | STE E360 |
| City Of The Provider | MILWAUKEE |
| Zip Code Of The Provider | 532331305 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 150 |
| Number Of Services | 4031 |
| Number Of Medicare Beneficiaries | 2833 |
| Total Submitted Charge Amount | 1003697 |
| Total Medicare Allowed Amount | 113626.71 |
| Total Medicare Payment Amount | 85473.24 |
| Total Medicare Standardized Payment Amount | 90741.16 |
| 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 | 150 |
| Number Of Medical Services | 4031 |
| Number Of Medicare Beneficiaries With Medical Services | 2833 |
| Total Medical Submitted Charge Amount | 1003697 |
| Total Medical Medicare Allowed Amount | 113626.71 |
| Total Medical Medicare Payment Amount | 85473.24 |
| Total Medical Medicare Standardized Payment Amount | 90741.16 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 621 |
| Number Of Beneficiaries Age 65 to 74 | 906 |
| Number Of Beneficiaries Age 75 to 84 | 772 |
| Number Of Beneficiaries Age Greater 84 | 534 |
| Number Of Female Beneficiaries | 1749 |
| Number Of Male Beneficiaries | 1084 |
| Number Of Non Hispanic White Beneficiaries | 2108 |
| Number Of Black or African American Beneficiaries | 546 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 94 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 41 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1827 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1006 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9266 |