| National Provider Identifier [NPI]: | 1639172075 |
| Last Name Of The Provider | CLARY |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. P C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 MAIN ST STE C |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHELBY |
| Zip Code Of The Provider | 594741906 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 1641 |
| Number Of Medicare Beneficiaries | 270 |
| Total Submitted Charge Amount | 105516.15 |
| Total Medicare Allowed Amount | 55635.27 |
| Total Medicare Payment Amount | 40691 |
| Total Medicare Standardized Payment Amount | 41331.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 248 |
| Number Of Medicare Beneficiaries With Drug Services | 138 |
| Total Drug Submitted ChargeAmount | 7295.15 |
| Total Drug Medicare AllowedAmount | 3499.37 |
| Total Drug Medicare PaymentAmount | 3221.43 |
| Total Drug Medicare Standardized Payment Amount | 3221.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 1393 |
| Number Of Medicare Beneficiaries With Medical Services | 258 |
| Total Medical Submitted Charge Amount | 98221 |
| Total Medical Medicare Allowed Amount | 52135.9 |
| Total Medical Medicare Payment Amount | 37469.57 |
| Total Medical Medicare Standardized Payment Amount | 38109.92 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 133 |
| Number Of Beneficiaries Age 75 to 84 | 79 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 146 |
| Number Of Male Beneficiaries | 124 |
| Number Of Non Hispanic White Beneficiaries | 258 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 233 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 20 |
| Percent Of With Hypertension | 39 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9125 |