| National Provider Identifier [NPI]: | 1740375641 |
| Last Name Of The Provider | EVANS |
| First Name Of The Provider | CLINTON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9601 INTERSTATE 630 EXIT 7 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LITTLE ROCK |
| Zip Code Of The Provider | 722057202 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 1697 |
| Number Of Medicare Beneficiaries | 1192 |
| Total Submitted Charge Amount | 555517 |
| Total Medicare Allowed Amount | 179619.08 |
| Total Medicare Payment Amount | 133488.08 |
| Total Medicare Standardized Payment Amount | 143108.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 1697 |
| Number Of Medicare Beneficiaries With Medical Services | 1192 |
| Total Medical Submitted Charge Amount | 555517 |
| Total Medical Medicare Allowed Amount | 179619.08 |
| Total Medical Medicare Payment Amount | 133488.08 |
| Total Medical Medicare Standardized Payment Amount | 143108.27 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 393 |
| Number Of Beneficiaries Age 65 to 74 | 337 |
| Number Of Beneficiaries Age 75 to 84 | 271 |
| Number Of Beneficiaries Age Greater 84 | 191 |
| Number Of Female Beneficiaries | 697 |
| Number Of Male Beneficiaries | 495 |
| Number Of Non Hispanic White Beneficiaries | 828 |
| Number Of Black or African American Beneficiaries | 346 |
| 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 | 753 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 439 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.9919 |