| National Provider Identifier [NPI]: | 1245333442 |
| Last Name Of The Provider | CLOTHIER |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3200 BELL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUBURN |
| Zip Code Of The Provider | 956039244 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 1335 |
| Number Of Medicare Beneficiaries | 358 |
| Total Submitted Charge Amount | 168925 |
| Total Medicare Allowed Amount | 101195.74 |
| Total Medicare Payment Amount | 75802.71 |
| Total Medicare Standardized Payment Amount | 73462.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 217 |
| Number Of Medicare Beneficiaries With Drug Services | 140 |
| Total Drug Submitted ChargeAmount | 9126 |
| Total Drug Medicare AllowedAmount | 4918.91 |
| Total Drug Medicare PaymentAmount | 4797.49 |
| Total Drug Medicare Standardized Payment Amount | 4797.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 1118 |
| Number Of Medicare Beneficiaries With Medical Services | 358 |
| Total Medical Submitted Charge Amount | 159799 |
| Total Medical Medicare Allowed Amount | 96276.83 |
| Total Medical Medicare Payment Amount | 71005.22 |
| Total Medical Medicare Standardized Payment Amount | 68665.04 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 209 |
| Number Of Beneficiaries Age 75 to 84 | 89 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 249 |
| Number Of Male Beneficiaries | 109 |
| Number Of Non Hispanic White Beneficiaries | 326 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 327 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8895 |