| National Provider Identifier [NPI]: | 1811055858 |
| Last Name Of The Provider | CLARKE |
| First Name Of The Provider | ANTHONY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7633 E JEFFERSON AVE |
| Street Address 2 Of The Provider | SUITE 340 |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 482143730 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 825 |
| Number Of Medicare Beneficiaries | 144 |
| Total Submitted Charge Amount | 47775 |
| Total Medicare Allowed Amount | 40786.19 |
| Total Medicare Payment Amount | 28709.15 |
| Total Medicare Standardized Payment Amount | 28416.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 44 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 1010 |
| Total Drug Medicare AllowedAmount | 760.01 |
| Total Drug Medicare PaymentAmount | 744.87 |
| Total Drug Medicare Standardized Payment Amount | 744.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 781 |
| Number Of Medicare Beneficiaries With Medical Services | 144 |
| Total Medical Submitted Charge Amount | 46765 |
| Total Medical Medicare Allowed Amount | 40026.18 |
| Total Medical Medicare Payment Amount | 27964.28 |
| Total Medical Medicare Standardized Payment Amount | 27671.17 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 57 |
| Number Of Beneficiaries Age 75 to 84 | 22 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 89 |
| Number Of Male Beneficiaries | 55 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 74 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4742 |