| National Provider Identifier [NPI]: | 1497941504 |
| Last Name Of The Provider | CLINE |
| First Name Of The Provider | KELLEY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1959 NE PACIFIC ST |
| Street Address 2 Of The Provider | C212, BOX 356340 |
| City Of The Provider | SEATTLE |
| Zip Code Of The Provider | 981950001 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 219 |
| Number Of Services | 4027 |
| Number Of Medicare Beneficiaries | 2396 |
| Total Submitted Charge Amount | 551278 |
| Total Medicare Allowed Amount | 148179.24 |
| Total Medicare Payment Amount | 108154.4 |
| Total Medicare Standardized Payment Amount | 109315.78 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 391 |
| Number Of Beneficiaries Age 65 to 74 | 850 |
| Number Of Beneficiaries Age 75 to 84 | 737 |
| Number Of Beneficiaries Age Greater 84 | 418 |
| Number Of Female Beneficiaries | 1302 |
| Number Of Male Beneficiaries | 1094 |
| Number Of Non Hispanic White Beneficiaries | 2217 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 98 |
| Number Of American Indian Alaska Native Beneficiaries | 25 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1839 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 557 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5533 |