| National Provider Identifier [NPI]: | 1205828159 |
| Last Name Of The Provider | HAUXWELL |
| First Name Of The Provider | CLINTON |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2214 E 29TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPOKANE |
| Zip Code Of The Provider | 992033939 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 127 |
| Number Of Services | 3616 |
| Number Of Medicare Beneficiaries | 314 |
| Total Submitted Charge Amount | 272294.78 |
| Total Medicare Allowed Amount | 108153.65 |
| Total Medicare Payment Amount | 79600.5 |
| Total Medicare Standardized Payment Amount | 80457.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 1024 |
| Number Of Medicare Beneficiaries With Drug Services | 85 |
| Total Drug Submitted ChargeAmount | 8476.18 |
| Total Drug Medicare AllowedAmount | 3900.7 |
| Total Drug Medicare PaymentAmount | 3610.41 |
| Total Drug Medicare Standardized Payment Amount | 3610.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 116 |
| Number Of Medical Services | 2592 |
| Number Of Medicare Beneficiaries With Medical Services | 314 |
| Total Medical Submitted Charge Amount | 263818.6 |
| Total Medical Medicare Allowed Amount | 104252.95 |
| Total Medical Medicare Payment Amount | 75990.09 |
| Total Medical Medicare Standardized Payment Amount | 76847.35 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 136 |
| Number Of Beneficiaries Age 75 to 84 | 102 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 142 |
| Number Of Male Beneficiaries | 172 |
| Number Of Non Hispanic White Beneficiaries | 302 |
| Number Of Black or African American Beneficiaries | |
| 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 | 296 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9587 |