| National Provider Identifier [NPI]: | 1942218961 |
| Last Name Of The Provider | SCHAFER |
| First Name Of The Provider | CLINTON |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 815 S MAPLE ST |
| Street Address 2 Of The Provider | NORTH PLATTE FORT CLINIC |
| City Of The Provider | NORTH PLATTE |
| Zip Code Of The Provider | 691015282 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 3321 |
| Number Of Medicare Beneficiaries | 641 |
| Total Submitted Charge Amount | 524100.3 |
| Total Medicare Allowed Amount | 188601.2 |
| Total Medicare Payment Amount | 136321.9 |
| Total Medicare Standardized Payment Amount | 148806.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 52 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 104 |
| Total Drug Medicare AllowedAmount | 49.8 |
| Total Drug Medicare PaymentAmount | 37.83 |
| Total Drug Medicare Standardized Payment Amount | 37.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 3269 |
| Number Of Medicare Beneficiaries With Medical Services | 641 |
| Total Medical Submitted Charge Amount | 523996.3 |
| Total Medical Medicare Allowed Amount | 188551.4 |
| Total Medical Medicare Payment Amount | 136284.07 |
| Total Medical Medicare Standardized Payment Amount | 148768.18 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 167 |
| Number Of Beneficiaries Age 75 to 84 | 231 |
| Number Of Beneficiaries Age Greater 84 | 174 |
| Number Of Female Beneficiaries | 370 |
| Number Of Male Beneficiaries | 271 |
| Number Of Non Hispanic White Beneficiaries | 607 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 492 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 149 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.7589 |