| National Provider Identifier [NPI]: | 1376555839 |
| Last Name Of The Provider | STINE |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3200 WESTHILL DR STE 210 |
| Street Address 2 Of The Provider | |
| City Of The Provider | WAUSAU |
| Zip Code Of The Provider | 544014707 |
| 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 | 187 |
| Number Of Services | 2952 |
| Number Of Medicare Beneficiaries | 1738 |
| Total Submitted Charge Amount | 991273.5 |
| Total Medicare Allowed Amount | 120112.34 |
| Total Medicare Payment Amount | 90752.1 |
| Total Medicare Standardized Payment Amount | 94927.2 |
| 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 | 187 |
| Number Of Medical Services | 2952 |
| Number Of Medicare Beneficiaries With Medical Services | 1738 |
| Total Medical Submitted Charge Amount | 991273.5 |
| Total Medical Medicare Allowed Amount | 120112.34 |
| Total Medical Medicare Payment Amount | 90752.1 |
| Total Medical Medicare Standardized Payment Amount | 94927.2 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 301 |
| Number Of Beneficiaries Age 65 to 74 | 591 |
| Number Of Beneficiaries Age 75 to 84 | 551 |
| Number Of Beneficiaries Age Greater 84 | 295 |
| Number Of Female Beneficiaries | 886 |
| Number Of Male Beneficiaries | 852 |
| Number Of Non Hispanic White Beneficiaries | 1626 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 46 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 38 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1249 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 489 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7872 |