| National Provider Identifier [NPI]: | 1376519223 |
| Last Name Of The Provider | CLEMENT |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D., PH.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8401 DATAPOINT DR |
| Street Address 2 Of The Provider | SUITE 600 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782295900 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 208 |
| Number Of Services | 8884 |
| Number Of Medicare Beneficiaries | 3637 |
| Total Submitted Charge Amount | 4702410.86 |
| Total Medicare Allowed Amount | 1165191.04 |
| Total Medicare Payment Amount | 898971.67 |
| Total Medicare Standardized Payment Amount | 989032.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2704 |
| Number Of Medicare Beneficiaries With Drug Services | 84 |
| Total Drug Submitted ChargeAmount | 5346 |
| Total Drug Medicare AllowedAmount | 2582.97 |
| Total Drug Medicare PaymentAmount | 2025.14 |
| Total Drug Medicare Standardized Payment Amount | 2025.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 204 |
| Number Of Medical Services | 6180 |
| Number Of Medicare Beneficiaries With Medical Services | 3636 |
| Total Medical Submitted Charge Amount | 4697064.86 |
| Total Medical Medicare Allowed Amount | 1162608.07 |
| Total Medical Medicare Payment Amount | 896946.53 |
| Total Medical Medicare Standardized Payment Amount | 987007.34 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 520 |
| Number Of Beneficiaries Age 65 to 74 | 1656 |
| Number Of Beneficiaries Age 75 to 84 | 1018 |
| Number Of Beneficiaries Age Greater 84 | 443 |
| Number Of Female Beneficiaries | 2228 |
| Number Of Male Beneficiaries | 1409 |
| Number Of Non Hispanic White Beneficiaries | 2569 |
| Number Of Black or African American Beneficiaries | 160 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 837 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3095 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 542 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5653 |