| National Provider Identifier [NPI]: | 1326058918 |
| Last Name Of The Provider | ELLIOTT |
| First Name Of The Provider | CLYDE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 304 CIRCLE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEST MONROE |
| Zip Code Of The Provider | 71291 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 947 |
| Number Of Medicare Beneficiaries | 240 |
| Total Submitted Charge Amount | 38116.66 |
| Total Medicare Allowed Amount | 25633.52 |
| Total Medicare Payment Amount | 19539.76 |
| Total Medicare Standardized Payment Amount | 20836.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 457 |
| Number Of Medicare Beneficiaries With Drug Services | 100 |
| Total Drug Submitted ChargeAmount | 2898.42 |
| Total Drug Medicare AllowedAmount | 1240.26 |
| Total Drug Medicare PaymentAmount | 1162.83 |
| Total Drug Medicare Standardized Payment Amount | 1162.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 490 |
| Number Of Medicare Beneficiaries With Medical Services | 240 |
| Total Medical Submitted Charge Amount | 35218.24 |
| Total Medical Medicare Allowed Amount | 24393.26 |
| Total Medical Medicare Payment Amount | 18376.93 |
| Total Medical Medicare Standardized Payment Amount | 19673.76 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 99 |
| Number Of Beneficiaries Age 75 to 84 | 86 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 134 |
| Number Of Male Beneficiaries | 106 |
| Number Of Non Hispanic White Beneficiaries | 215 |
| 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 | 206 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2332 |