| National Provider Identifier [NPI]: | 1477649234 |
| Last Name Of The Provider | CLARK |
| First Name Of The Provider | FRANCIS |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3584 W 9000 S |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | WEST JORDAN |
| Zip Code Of The Provider | 840885711 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 1151 |
| Number Of Medicare Beneficiaries | 214 |
| Total Submitted Charge Amount | 248912.41 |
| Total Medicare Allowed Amount | 83254.83 |
| Total Medicare Payment Amount | 60264.51 |
| Total Medicare Standardized Payment Amount | 64126.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 150 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 1499.36 |
| Total Drug Medicare AllowedAmount | 266.61 |
| Total Drug Medicare PaymentAmount | 197.59 |
| Total Drug Medicare Standardized Payment Amount | 197.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 1001 |
| Number Of Medicare Beneficiaries With Medical Services | 214 |
| Total Medical Submitted Charge Amount | 247413.05 |
| Total Medical Medicare Allowed Amount | 82988.22 |
| Total Medical Medicare Payment Amount | 60066.92 |
| Total Medical Medicare Standardized Payment Amount | 63928.58 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 99 |
| Number Of Beneficiaries Age 75 to 84 | 68 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 126 |
| Number Of Male Beneficiaries | 88 |
| Number Of Non Hispanic White Beneficiaries | 195 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 202 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2206 |