| National Provider Identifier [NPI]: | 1588839534 |
| Last Name Of The Provider | CLAIR |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5803 NEAL AVE N |
| Street Address 2 Of The Provider | |
| City Of The Provider | OAK PARK HEIGHTS |
| Zip Code Of The Provider | 550822177 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 735 |
| Number Of Medicare Beneficiaries | 161 |
| Total Submitted Charge Amount | 258727 |
| Total Medicare Allowed Amount | 68740.76 |
| Total Medicare Payment Amount | 52243.36 |
| Total Medicare Standardized Payment Amount | 55033.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 81 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 324 |
| Total Drug Medicare AllowedAmount | 144.59 |
| Total Drug Medicare PaymentAmount | 110.4 |
| Total Drug Medicare Standardized Payment Amount | 110.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 654 |
| Number Of Medicare Beneficiaries With Medical Services | 161 |
| Total Medical Submitted Charge Amount | 258403 |
| Total Medical Medicare Allowed Amount | 68596.17 |
| Total Medical Medicare Payment Amount | 52132.96 |
| Total Medical Medicare Standardized Payment Amount | 54923.4 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 66 |
| Number Of Beneficiaries Age 75 to 84 | 45 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 102 |
| Number Of Male Beneficiaries | 59 |
| 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 | 119 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1517 |