| National Provider Identifier [NPI]: | 1508838566 |
| Last Name Of The Provider | VANLANDINGHAM |
| First Name Of The Provider | CLINT |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 225 PHYSICIANS PARK |
| Street Address 2 Of The Provider | STE 102 |
| City Of The Provider | POPLAR BLUFF |
| Zip Code Of The Provider | 639013956 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 6169 |
| Number Of Medicare Beneficiaries | 1031 |
| Total Submitted Charge Amount | 671678.59 |
| Total Medicare Allowed Amount | 344865.89 |
| Total Medicare Payment Amount | 250569.36 |
| Total Medicare Standardized Payment Amount | 273423.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 953 |
| Number Of Medicare Beneficiaries With Drug Services | 245 |
| Total Drug Submitted ChargeAmount | 36943.4 |
| Total Drug Medicare AllowedAmount | 17729.61 |
| Total Drug Medicare PaymentAmount | 13880.43 |
| Total Drug Medicare Standardized Payment Amount | 13880.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 5216 |
| Number Of Medicare Beneficiaries With Medical Services | 1031 |
| Total Medical Submitted Charge Amount | 634735.19 |
| Total Medical Medicare Allowed Amount | 327136.28 |
| Total Medical Medicare Payment Amount | 236688.93 |
| Total Medical Medicare Standardized Payment Amount | 259543.55 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 245 |
| Number Of Beneficiaries Age 65 to 74 | 401 |
| Number Of Beneficiaries Age 75 to 84 | 264 |
| Number Of Beneficiaries Age Greater 84 | 121 |
| Number Of Female Beneficiaries | 652 |
| Number Of Male Beneficiaries | 379 |
| Number Of Non Hispanic White Beneficiaries | 1005 |
| 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 | 693 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 338 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3817 |