| National Provider Identifier [NPI]: | 1578631784 |
| Last Name Of The Provider | CLARK |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2780 BOB WALLACE AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HUNTSVILLE |
| Zip Code Of The Provider | 358054104 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 55503 |
| Number Of Medicare Beneficiaries | 811 |
| Total Submitted Charge Amount | 2831102.8 |
| Total Medicare Allowed Amount | 890368.1 |
| Total Medicare Payment Amount | 687928.2 |
| Total Medicare Standardized Payment Amount | 747190.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 51312 |
| Number Of Medicare Beneficiaries With Drug Services | 325 |
| Total Drug Submitted ChargeAmount | 130757.8 |
| Total Drug Medicare AllowedAmount | 42368.64 |
| Total Drug Medicare PaymentAmount | 32515.91 |
| Total Drug Medicare Standardized Payment Amount | 32515.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 4191 |
| Number Of Medicare Beneficiaries With Medical Services | 810 |
| Total Medical Submitted Charge Amount | 2700345 |
| Total Medical Medicare Allowed Amount | 847999.46 |
| Total Medical Medicare Payment Amount | 655412.29 |
| Total Medical Medicare Standardized Payment Amount | 714674.19 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 198 |
| Number Of Beneficiaries Age 65 to 74 | 278 |
| Number Of Beneficiaries Age 75 to 84 | 249 |
| Number Of Beneficiaries Age Greater 84 | 86 |
| Number Of Female Beneficiaries | 422 |
| Number Of Male Beneficiaries | 389 |
| Number Of Non Hispanic White Beneficiaries | 583 |
| Number Of Black or African American Beneficiaries | 204 |
| 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 | 609 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 202 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 60 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 3.939 |