| National Provider Identifier [NPI]: | 1366447583 |
| Last Name Of The Provider | FIELDS |
| First Name Of The Provider | CLIVE |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9055 KATY FWY |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770241624 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 3514 |
| Number Of Medicare Beneficiaries | 630 |
| Total Submitted Charge Amount | 256024.21 |
| Total Medicare Allowed Amount | 171370.84 |
| Total Medicare Payment Amount | 124464.04 |
| Total Medicare Standardized Payment Amount | 125074.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 355 |
| Number Of Medicare Beneficiaries With Drug Services | 200 |
| Total Drug Submitted ChargeAmount | 11130 |
| Total Drug Medicare AllowedAmount | 6962.01 |
| Total Drug Medicare PaymentAmount | 6721.66 |
| Total Drug Medicare Standardized Payment Amount | 6721.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 3159 |
| Number Of Medicare Beneficiaries With Medical Services | 630 |
| Total Medical Submitted Charge Amount | 244894.21 |
| Total Medical Medicare Allowed Amount | 164408.83 |
| Total Medical Medicare Payment Amount | 117742.38 |
| Total Medical Medicare Standardized Payment Amount | 118352.5 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 394 |
| Number Of Beneficiaries Age 75 to 84 | 160 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 347 |
| Number Of Male Beneficiaries | 283 |
| Number Of Non Hispanic White Beneficiaries | 576 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 616 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 2 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 3 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.7741 |