| National Provider Identifier [NPI]: | 1912333196 |
| Last Name Of The Provider | CLINGAN |
| First Name Of The Provider | CHELLIE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | APRN,FNP-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1520 S BRYANT AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | EDMOND |
| Zip Code Of The Provider | 730136028 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 583 |
| Number Of Medicare Beneficiaries | 266 |
| Total Submitted Charge Amount | 18530.36 |
| Total Medicare Allowed Amount | 17557.71 |
| Total Medicare Payment Amount | 15975.29 |
| Total Medicare Standardized Payment Amount | 17729.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 266 |
| Number Of Medicare Beneficiaries With Drug Services | 229 |
| Total Drug Submitted ChargeAmount | 8820.36 |
| Total Drug Medicare AllowedAmount | 8761.08 |
| Total Drug Medicare PaymentAmount | 8555.04 |
| Total Drug Medicare Standardized Payment Amount | 8555.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 317 |
| Number Of Medicare Beneficiaries With Medical Services | 265 |
| Total Medical Submitted Charge Amount | 9710 |
| Total Medical Medicare Allowed Amount | 8796.63 |
| Total Medical Medicare Payment Amount | 7420.25 |
| Total Medical Medicare Standardized Payment Amount | 9174.36 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 154 |
| Number Of Beneficiaries Age 75 to 84 | 75 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 152 |
| Number Of Male Beneficiaries | 114 |
| Number Of Non Hispanic White Beneficiaries | 247 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 5 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7409 |