National Provider Identifier [NPI]: |
1013907435 |
Last Name Of The Provider |
CLINE |
First Name Of The Provider |
MARSHA |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M. D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1106 DRUID RD S |
Street Address 2 Of The Provider |
SUITE 302 |
City Of The Provider |
CLEARWATER |
Zip Code Of The Provider |
337563846 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
9607 |
Number Of Medicare Beneficiaries |
2997 |
Total Submitted Charge Amount |
1196437.2 |
Total Medicare Allowed Amount |
472526.35 |
Total Medicare Payment Amount |
421748.91 |
Total Medicare Standardized Payment Amount |
429864.48 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
3490 |
Number Of Medicare Beneficiaries With Drug Services |
45 |
Total Drug Submitted ChargeAmount |
3071.2 |
Total Drug Medicare AllowedAmount |
1424.74 |
Total Drug Medicare PaymentAmount |
1117 |
Total Drug Medicare Standardized Payment Amount |
1117 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
6117 |
Number Of Medicare Beneficiaries With Medical Services |
2996 |
Total Medical Submitted Charge Amount |
1193366 |
Total Medical Medicare Allowed Amount |
471101.61 |
Total Medical Medicare Payment Amount |
420631.91 |
Total Medical Medicare Standardized Payment Amount |
428747.48 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
202 |
Number Of Beneficiaries Age 65 to 74 |
1501 |
Number Of Beneficiaries Age 75 to 84 |
981 |
Number Of Beneficiaries Age Greater 84 |
313 |
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
2761 |
Number Of Black or African American Beneficiaries |
80 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
88 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
33 |
Number Of Beneficiaries With Medicare Only Entitlement |
2732 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
265 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9372 |