| National Provider Identifier [NPI]: | 1336142348 |
| Last Name Of The Provider | CLEMENT |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5330 N OAK TRFY |
| Street Address 2 Of The Provider | #102 |
| City Of The Provider | KANSAS CITY |
| Zip Code Of The Provider | 641184699 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 1788 |
| Number Of Medicare Beneficiaries | 799 |
| Total Submitted Charge Amount | 554551.5 |
| Total Medicare Allowed Amount | 183200.74 |
| Total Medicare Payment Amount | 140629.58 |
| Total Medicare Standardized Payment Amount | 142747.49 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 118 |
| Number Of Beneficiaries Age 65 to 74 | 295 |
| Number Of Beneficiaries Age 75 to 84 | 249 |
| Number Of Beneficiaries Age Greater 84 | 137 |
| Number Of Female Beneficiaries | 462 |
| Number Of Male Beneficiaries | 337 |
| Number Of Non Hispanic White Beneficiaries | 706 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 639 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 160 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7316 |