| National Provider Identifier [NPI]: | 1467754267 |
| Last Name Of The Provider | AWISHES |
| First Name Of The Provider | CLAY |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | CRNA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 718 N MACOMB ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MONROE |
| Zip Code Of The Provider | 481627815 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | CRNA |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 315 |
| Number Of Medicare Beneficiaries | 294 |
| Total Submitted Charge Amount | 189003 |
| Total Medicare Allowed Amount | 31768.17 |
| Total Medicare Payment Amount | 24861.68 |
| Total Medicare Standardized Payment Amount | 25120.85 |
| 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 | 57 |
| Number Of Medical Services | 315 |
| Number Of Medicare Beneficiaries With Medical Services | 294 |
| Total Medical Submitted Charge Amount | 189003 |
| Total Medical Medicare Allowed Amount | 31768.17 |
| Total Medical Medicare Payment Amount | 24861.68 |
| Total Medical Medicare Standardized Payment Amount | 25120.85 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 119 |
| Number Of Beneficiaries Age 75 to 84 | 72 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 156 |
| Number Of Male Beneficiaries | 138 |
| Number Of Non Hispanic White Beneficiaries | 281 |
| 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 | 211 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6516 |