| National Provider Identifier [NPI]: | 1245279900 |
| Last Name Of The Provider | CLARY |
| First Name Of The Provider | CONNIE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | ANP/GNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 105 S. HOUGHTON ROAD |
| Street Address 2 Of The Provider | #101 |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 857486732 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 660 |
| Number Of Medicare Beneficiaries | 179 |
| Total Submitted Charge Amount | 58513.3 |
| Total Medicare Allowed Amount | 39044.83 |
| Total Medicare Payment Amount | 26360.75 |
| Total Medicare Standardized Payment Amount | 32098.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 74 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 1952.15 |
| Total Drug Medicare AllowedAmount | 1319.05 |
| Total Drug Medicare PaymentAmount | 1278.26 |
| Total Drug Medicare Standardized Payment Amount | 1278.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 586 |
| Number Of Medicare Beneficiaries With Medical Services | 179 |
| Total Medical Submitted Charge Amount | 56561.15 |
| Total Medical Medicare Allowed Amount | 37725.78 |
| Total Medical Medicare Payment Amount | 25082.49 |
| Total Medical Medicare Standardized Payment Amount | 30820.52 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 100 |
| Number Of Beneficiaries Age 75 to 84 | 49 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 56 |
| Number Of Non Hispanic White Beneficiaries | 166 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8189 |