| National Provider Identifier [NPI]: | 1639170996 |
| Last Name Of The Provider | KLINE |
| First Name Of The Provider | MITCHELL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1214 SPRING ST |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | JEFFERSONVILLE |
| Zip Code Of The Provider | 471303704 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 172 |
| Number Of Services | 14203 |
| Number Of Medicare Beneficiaries | 2324 |
| Total Submitted Charge Amount | 1678199.06 |
| Total Medicare Allowed Amount | 422898.03 |
| Total Medicare Payment Amount | 319227.51 |
| Total Medicare Standardized Payment Amount | 345343.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 10623 |
| Number Of Medicare Beneficiaries With Drug Services | 249 |
| Total Drug Submitted ChargeAmount | 25681 |
| Total Drug Medicare AllowedAmount | 6162.06 |
| Total Drug Medicare PaymentAmount | 4727.43 |
| Total Drug Medicare Standardized Payment Amount | 4727.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 167 |
| Number Of Medical Services | 3580 |
| Number Of Medicare Beneficiaries With Medical Services | 2324 |
| Total Medical Submitted Charge Amount | 1652518.06 |
| Total Medical Medicare Allowed Amount | 416735.97 |
| Total Medical Medicare Payment Amount | 314500.08 |
| Total Medical Medicare Standardized Payment Amount | 340616.35 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 579 |
| Number Of Beneficiaries Age 65 to 74 | 907 |
| Number Of Beneficiaries Age 75 to 84 | 586 |
| Number Of Beneficiaries Age Greater 84 | 252 |
| Number Of Female Beneficiaries | 1439 |
| Number Of Male Beneficiaries | 885 |
| Number Of Non Hispanic White Beneficiaries | 2199 |
| Number Of Black or African American Beneficiaries | 77 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1689 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 635 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5498 |