| National Provider Identifier [NPI]: | 1053348037 |
| Last Name Of The Provider | KINGSLEY |
| First Name Of The Provider | CLINT |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 HOSPITAL DR |
| Street Address 2 Of The Provider | DC116.71 |
| City Of The Provider | COLUMBIA |
| Zip Code Of The Provider | 652121000 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 165 |
| Number Of Services | 100494 |
| Number Of Medicare Beneficiaries | 1494 |
| Total Submitted Charge Amount | 4090445.5 |
| Total Medicare Allowed Amount | 1665740.96 |
| Total Medicare Payment Amount | 1279916.41 |
| Total Medicare Standardized Payment Amount | 1296025.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 74 |
| Number Of Drug Services | 90194 |
| Number Of Medicare Beneficiaries With Drug Services | 299 |
| Total Drug Submitted ChargeAmount | 3217963.5 |
| Total Drug Medicare AllowedAmount | 1278812.26 |
| Total Drug Medicare PaymentAmount | 982569.77 |
| Total Drug Medicare Standardized Payment Amount | 982569.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 91 |
| Number Of Medical Services | 10300 |
| Number Of Medicare Beneficiaries With Medical Services | 1494 |
| Total Medical Submitted Charge Amount | 872482 |
| Total Medical Medicare Allowed Amount | 386928.7 |
| Total Medical Medicare Payment Amount | 297346.64 |
| Total Medical Medicare Standardized Payment Amount | 313455.93 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 212 |
| Number Of Beneficiaries Age 65 to 74 | 588 |
| Number Of Beneficiaries Age 75 to 84 | 548 |
| Number Of Beneficiaries Age Greater 84 | 146 |
| Number Of Female Beneficiaries | 842 |
| Number Of Male Beneficiaries | 652 |
| Number Of Non Hispanic White Beneficiaries | 1270 |
| Number Of Black or African American Beneficiaries | 191 |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1286 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 208 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 34 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.9973 |