| National Provider Identifier [NPI]: | 1841200284 |
| Last Name Of The Provider | ALLDREDGE |
| First Name Of The Provider | CLARON |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4360 WASHINGTON BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | OGDEN |
| Zip Code Of The Provider | 844031866 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 5535 |
| Number Of Medicare Beneficiaries | 677 |
| Total Submitted Charge Amount | 2093137.45 |
| Total Medicare Allowed Amount | 1424886.74 |
| Total Medicare Payment Amount | 1099889.26 |
| Total Medicare Standardized Payment Amount | 1111902.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1739 |
| Number Of Medicare Beneficiaries With Drug Services | 197 |
| Total Drug Submitted ChargeAmount | 1224245 |
| Total Drug Medicare AllowedAmount | 1000689.55 |
| Total Drug Medicare PaymentAmount | 779223.93 |
| Total Drug Medicare Standardized Payment Amount | 779223.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 3796 |
| Number Of Medicare Beneficiaries With Medical Services | 676 |
| Total Medical Submitted Charge Amount | 868892.45 |
| Total Medical Medicare Allowed Amount | 424197.19 |
| Total Medical Medicare Payment Amount | 320665.33 |
| Total Medical Medicare Standardized Payment Amount | 332678.67 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 236 |
| Number Of Beneficiaries Age 75 to 84 | 256 |
| Number Of Beneficiaries Age Greater 84 | 159 |
| Number Of Female Beneficiaries | 405 |
| Number Of Male Beneficiaries | 272 |
| Number Of Non Hispanic White Beneficiaries | 637 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 648 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0769 |