| National Provider Identifier [NPI]: | 1184615841 |
| Last Name Of The Provider | KLINE |
| First Name Of The Provider | JOSHUA |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6130 TRIER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WAYNE |
| Zip Code Of The Provider | 468155378 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 1230 |
| Number Of Medicare Beneficiaries | 245 |
| Total Submitted Charge Amount | 150954 |
| Total Medicare Allowed Amount | 77647.33 |
| Total Medicare Payment Amount | 53205.57 |
| Total Medicare Standardized Payment Amount | 56801.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 285 |
| Number Of Medicare Beneficiaries With Drug Services | 123 |
| Total Drug Submitted ChargeAmount | 21272 |
| Total Drug Medicare AllowedAmount | 8119.87 |
| Total Drug Medicare PaymentAmount | 7834.7 |
| Total Drug Medicare Standardized Payment Amount | 7834.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 945 |
| Number Of Medicare Beneficiaries With Medical Services | 245 |
| Total Medical Submitted Charge Amount | 129682 |
| Total Medical Medicare Allowed Amount | 69527.46 |
| Total Medical Medicare Payment Amount | 45370.87 |
| Total Medical Medicare Standardized Payment Amount | 48966.33 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 100 |
| Number Of Beneficiaries Age 75 to 84 | 64 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 144 |
| Number Of Male Beneficiaries | 101 |
| Number Of Non Hispanic White Beneficiaries | 227 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 217 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0171 |