| National Provider Identifier [NPI]: | 1861495012 |
| Last Name Of The Provider | CLEMONS |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1009 NORTH STATE OF FRANKLIN ACCESS ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | JOHNSON CITY |
| Zip Code Of The Provider | 37604 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 7026 |
| Number Of Medicare Beneficiaries | 1266 |
| Total Submitted Charge Amount | 611639 |
| Total Medicare Allowed Amount | 346790.77 |
| Total Medicare Payment Amount | 248256.8 |
| Total Medicare Standardized Payment Amount | 264183.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 82 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 18440 |
| Total Drug Medicare AllowedAmount | 18367.07 |
| Total Drug Medicare PaymentAmount | 13996.22 |
| Total Drug Medicare Standardized Payment Amount | 13996.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 6944 |
| Number Of Medicare Beneficiaries With Medical Services | 1266 |
| Total Medical Submitted Charge Amount | 593199 |
| Total Medical Medicare Allowed Amount | 328423.7 |
| Total Medical Medicare Payment Amount | 234260.58 |
| Total Medical Medicare Standardized Payment Amount | 250187.38 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 630 |
| Number Of Beneficiaries Age 75 to 84 | 435 |
| Number Of Beneficiaries Age Greater 84 | 144 |
| Number Of Female Beneficiaries | 614 |
| Number Of Male Beneficiaries | 652 |
| Number Of Non Hispanic White Beneficiaries | 1242 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 1208 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9396 |