| National Provider Identifier [NPI]: | 1427086677 |
| Last Name Of The Provider | CLEMENS |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3131 N MCMULLEN BOOTH RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLEARWATER |
| Zip Code Of The Provider | 337612008 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 3382 |
| Number Of Medicare Beneficiaries | 612 |
| Total Submitted Charge Amount | 427779.87 |
| Total Medicare Allowed Amount | 293627.79 |
| Total Medicare Payment Amount | 222420.96 |
| Total Medicare Standardized Payment Amount | 224295.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 403 |
| Number Of Medicare Beneficiaries With Drug Services | 208 |
| Total Drug Submitted ChargeAmount | 12001 |
| Total Drug Medicare AllowedAmount | 7969.56 |
| Total Drug Medicare PaymentAmount | 7758.07 |
| Total Drug Medicare Standardized Payment Amount | 7758.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 2979 |
| Number Of Medicare Beneficiaries With Medical Services | 612 |
| Total Medical Submitted Charge Amount | 415778.87 |
| Total Medical Medicare Allowed Amount | 285658.23 |
| Total Medical Medicare Payment Amount | 214662.89 |
| Total Medical Medicare Standardized Payment Amount | 216537.46 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 258 |
| Number Of Beneficiaries Age 75 to 84 | 200 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 319 |
| Number Of Male Beneficiaries | 293 |
| Number Of Non Hispanic White Beneficiaries | 578 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 574 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 71 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0447 |