| National Provider Identifier [NPI]: | 1306829916 |
| Last Name Of The Provider | CLEMONS |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 845 OLIVE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHREVEPORT |
| Zip Code Of The Provider | 711042101 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 13026 |
| Number Of Medicare Beneficiaries | 1678 |
| Total Submitted Charge Amount | 876315 |
| Total Medicare Allowed Amount | 543029.52 |
| Total Medicare Payment Amount | 380774.42 |
| Total Medicare Standardized Payment Amount | 410464.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1916 |
| Number Of Medicare Beneficiaries With Drug Services | 378 |
| Total Drug Submitted ChargeAmount | 7568 |
| Total Drug Medicare AllowedAmount | 3746.93 |
| Total Drug Medicare PaymentAmount | 2738.68 |
| Total Drug Medicare Standardized Payment Amount | 2738.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 106 |
| Number Of Medical Services | 11110 |
| Number Of Medicare Beneficiaries With Medical Services | 1678 |
| Total Medical Submitted Charge Amount | 868747 |
| Total Medical Medicare Allowed Amount | 539282.59 |
| Total Medical Medicare Payment Amount | 378035.74 |
| Total Medical Medicare Standardized Payment Amount | 407725.95 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 105 |
| Number Of Beneficiaries Age 65 to 74 | 752 |
| Number Of Beneficiaries Age 75 to 84 | 587 |
| Number Of Beneficiaries Age Greater 84 | 234 |
| Number Of Female Beneficiaries | 854 |
| Number Of Male Beneficiaries | 824 |
| Number Of Non Hispanic White Beneficiaries | 1541 |
| Number Of Black or African American Beneficiaries | 106 |
| 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 | 1567 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 111 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0411 |