| National Provider Identifier [NPI]: | 1508854811 |
| Last Name Of The Provider | TRUESDELL |
| First Name Of The Provider | CLARA |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 185 OLD PEACHTREE RD NW |
| Street Address 2 Of The Provider | |
| City Of The Provider | SUWANEE |
| Zip Code Of The Provider | 300242511 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 2394 |
| Number Of Medicare Beneficiaries | 312 |
| Total Submitted Charge Amount | 611300 |
| Total Medicare Allowed Amount | 373985.9 |
| Total Medicare Payment Amount | 285759.87 |
| Total Medicare Standardized Payment Amount | 287361.24 |
| 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 | 22 |
| Number Of Medical Services | 2394 |
| Number Of Medicare Beneficiaries With Medical Services | 312 |
| Total Medical Submitted Charge Amount | 611300 |
| Total Medical Medicare Allowed Amount | 373985.9 |
| Total Medical Medicare Payment Amount | 285759.87 |
| Total Medical Medicare Standardized Payment Amount | 287361.24 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 118 |
| Number Of Beneficiaries Age 65 to 74 | 101 |
| Number Of Beneficiaries Age 75 to 84 | 67 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 171 |
| Number Of Male Beneficiaries | 141 |
| Number Of Non Hispanic White Beneficiaries | 122 |
| Number Of Black or African American Beneficiaries | 167 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| 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 | 224 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 88 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 3.971 |