| National Provider Identifier [NPI]: | 1255403887 |
| Last Name Of The Provider | CLEM-BADHWAR |
| First Name Of The Provider | ANNA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1140 CHARLES LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | MARYSVILLE |
| Zip Code Of The Provider | 430409797 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 229 |
| Number Of Medicare Beneficiaries | 36 |
| Total Submitted Charge Amount | 26299.9 |
| Total Medicare Allowed Amount | 18221.11 |
| Total Medicare Payment Amount | 13123.24 |
| Total Medicare Standardized Payment Amount | 14379.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1120.9 |
| Total Drug Medicare AllowedAmount | 651.42 |
| Total Drug Medicare PaymentAmount | 636.43 |
| Total Drug Medicare Standardized Payment Amount | 636.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 203 |
| Number Of Medicare Beneficiaries With Medical Services | 36 |
| Total Medical Submitted Charge Amount | 25179 |
| Total Medical Medicare Allowed Amount | 17569.69 |
| Total Medical Medicare Payment Amount | 12486.81 |
| Total Medical Medicare Standardized Payment Amount | 13743.42 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 18 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8982 |