| National Provider Identifier [NPI]: | 1326100835 |
| Last Name Of The Provider | CLEWELL |
| First Name Of The Provider | KATHY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 15644 POMERADO RD |
| Street Address 2 Of The Provider | #105 |
| City Of The Provider | POWAY |
| Zip Code Of The Provider | 92064 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 3398 |
| Number Of Medicare Beneficiaries | 338 |
| Total Submitted Charge Amount | 248599 |
| Total Medicare Allowed Amount | 169157.08 |
| Total Medicare Payment Amount | 131348.45 |
| Total Medicare Standardized Payment Amount | 127498.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1124 |
| Number Of Medicare Beneficiaries With Drug Services | 173 |
| Total Drug Submitted ChargeAmount | 30310 |
| Total Drug Medicare AllowedAmount | 25558.64 |
| Total Drug Medicare PaymentAmount | 22454.78 |
| Total Drug Medicare Standardized Payment Amount | 22454.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 2274 |
| Number Of Medicare Beneficiaries With Medical Services | 338 |
| Total Medical Submitted Charge Amount | 218289 |
| Total Medical Medicare Allowed Amount | 143598.44 |
| Total Medical Medicare Payment Amount | 108893.67 |
| Total Medical Medicare Standardized Payment Amount | 105043.84 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 145 |
| Number Of Beneficiaries Age 75 to 84 | 129 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 251 |
| Number Of Male Beneficiaries | 87 |
| Number Of Non Hispanic White Beneficiaries | 301 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0088 |