| National Provider Identifier [NPI]: | 1316940919 |
| Last Name Of The Provider | KING |
| First Name Of The Provider | CLAIRE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1375 N 10TH AVE |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | STAYTON |
| Zip Code Of The Provider | 973832099 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 948 |
| Number Of Medicare Beneficiaries | 119 |
| Total Submitted Charge Amount | 107882 |
| Total Medicare Allowed Amount | 53793.9 |
| Total Medicare Payment Amount | 41007.03 |
| Total Medicare Standardized Payment Amount | 42031.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 200 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 8440 |
| Total Drug Medicare AllowedAmount | 6861.67 |
| Total Drug Medicare PaymentAmount | 6524.07 |
| Total Drug Medicare Standardized Payment Amount | 6524.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 748 |
| Number Of Medicare Beneficiaries With Medical Services | 119 |
| Total Medical Submitted Charge Amount | 99442 |
| Total Medical Medicare Allowed Amount | 46932.23 |
| Total Medical Medicare Payment Amount | 34482.96 |
| Total Medical Medicare Standardized Payment Amount | 35507.5 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 51 |
| Number Of Beneficiaries Age 75 to 84 | 29 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 93 |
| Number Of Male Beneficiaries | 26 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 81 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1029 |