| National Provider Identifier [NPI]: | 1104802347 |
| Last Name Of The Provider | CLEMENTS |
| First Name Of The Provider | IAN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 1ST ST SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCHESTER |
| Zip Code Of The Provider | 559050001 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 16686 |
| Number Of Medicare Beneficiaries | 11288 |
| Total Submitted Charge Amount | 543849.34 |
| Total Medicare Allowed Amount | 275244.55 |
| Total Medicare Payment Amount | 203347.26 |
| Total Medicare Standardized Payment Amount | 224628.42 |
| 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 | 31 |
| Number Of Medical Services | 16686 |
| Number Of Medicare Beneficiaries With Medical Services | 11288 |
| Total Medical Submitted Charge Amount | 543849.34 |
| Total Medical Medicare Allowed Amount | 275244.55 |
| Total Medical Medicare Payment Amount | 203347.26 |
| Total Medical Medicare Standardized Payment Amount | 224628.42 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 1472 |
| Number Of Beneficiaries Age 65 to 74 | 4248 |
| Number Of Beneficiaries Age 75 to 84 | 3869 |
| Number Of Beneficiaries Age Greater 84 | 1699 |
| Number Of Female Beneficiaries | 5251 |
| Number Of Male Beneficiaries | 6037 |
| Number Of Non Hispanic White Beneficiaries | 10724 |
| Number Of Black or African American Beneficiaries | 131 |
| Number Of AsianPacific Islander Beneficiaries | 99 |
| Number Of Hispanic Beneficiaries | 116 |
| Number Of American Indian Alaska Native Beneficiaries | 52 |
| Number Of Beneficiaries With Race Not Else where Classified | 166 |
| Number Of Beneficiaries With Medicare Only Entitlement | 9922 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1366 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5008 |