| National Provider Identifier [NPI]: | 1609841691 |
| Last Name Of The Provider | CLAYTON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 NE 14TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WASHINGTON |
| Zip Code Of The Provider | 475012137 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 714 |
| Number Of Medicare Beneficiaries | 341 |
| Total Submitted Charge Amount | 424936.57 |
| Total Medicare Allowed Amount | 159503.36 |
| Total Medicare Payment Amount | 122307.62 |
| Total Medicare Standardized Payment Amount | 130658.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 714 |
| Number Of Medicare Beneficiaries With Medical Services | 341 |
| Total Medical Submitted Charge Amount | 424936.57 |
| Total Medical Medicare Allowed Amount | 159503.36 |
| Total Medical Medicare Payment Amount | 122307.62 |
| Total Medical Medicare Standardized Payment Amount | 130658.63 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 144 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 191 |
| Number Of Male Beneficiaries | 150 |
| Number Of Non Hispanic White Beneficiaries | 327 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 232 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 109 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.4997 |