| National Provider Identifier [NPI]: | 1295932648 |
| Last Name Of The Provider | CLEAVER |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1316 COUNTRY CLUB DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | KIRKSVILLE |
| Zip Code Of The Provider | 635015362 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 10599 |
| Number Of Medicare Beneficiaries | 1817 |
| Total Submitted Charge Amount | 656796.63 |
| Total Medicare Allowed Amount | 600131.93 |
| Total Medicare Payment Amount | 443386.67 |
| Total Medicare Standardized Payment Amount | 474273.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 106 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 18232.99 |
| Total Drug Medicare AllowedAmount | 18009.59 |
| Total Drug Medicare PaymentAmount | 14004.4 |
| Total Drug Medicare Standardized Payment Amount | 14004.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 10493 |
| Number Of Medicare Beneficiaries With Medical Services | 1817 |
| Total Medical Submitted Charge Amount | 638563.64 |
| Total Medical Medicare Allowed Amount | 582122.34 |
| Total Medical Medicare Payment Amount | 429382.27 |
| Total Medical Medicare Standardized Payment Amount | 460269.58 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 139 |
| Number Of Beneficiaries Age 65 to 74 | 736 |
| Number Of Beneficiaries Age 75 to 84 | 674 |
| Number Of Beneficiaries Age Greater 84 | 268 |
| Number Of Female Beneficiaries | 923 |
| Number Of Male Beneficiaries | 894 |
| Number Of Non Hispanic White Beneficiaries | 1802 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1582 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 235 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9628 |