| National Provider Identifier [NPI]: | 1053408476 |
| Last Name Of The Provider | CLARK |
| First Name Of The Provider | STEVEN |
| 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 | 810 E SUNFLOWER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLEVELAND |
| Zip Code Of The Provider | 387322800 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 263 |
| Number Of Services | 49506 |
| Number Of Medicare Beneficiaries | 2203 |
| Total Submitted Charge Amount | 2119687.08 |
| Total Medicare Allowed Amount | 950570.81 |
| Total Medicare Payment Amount | 736142.53 |
| Total Medicare Standardized Payment Amount | 792982.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 25 |
| Number Of Drug Services | 24295 |
| Number Of Medicare Beneficiaries With Drug Services | 702 |
| Total Drug Submitted ChargeAmount | 120078.85 |
| Total Drug Medicare AllowedAmount | 58274.37 |
| Total Drug Medicare PaymentAmount | 44404.79 |
| Total Drug Medicare Standardized Payment Amount | 44404.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 238 |
| Number Of Medical Services | 25211 |
| Number Of Medicare Beneficiaries With Medical Services | 2203 |
| Total Medical Submitted Charge Amount | 1999608.23 |
| Total Medical Medicare Allowed Amount | 892296.44 |
| Total Medical Medicare Payment Amount | 691737.74 |
| Total Medical Medicare Standardized Payment Amount | 748577.94 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 572 |
| Number Of Beneficiaries Age 65 to 74 | 817 |
| Number Of Beneficiaries Age 75 to 84 | 513 |
| Number Of Beneficiaries Age Greater 84 | 301 |
| Number Of Female Beneficiaries | 1295 |
| Number Of Male Beneficiaries | 908 |
| Number Of Non Hispanic White Beneficiaries | 976 |
| Number Of Black or African American Beneficiaries | 1195 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1077 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1126 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.731 |