| National Provider Identifier [NPI]: | 1215916283 |
| Last Name Of The Provider | CLAUSS |
| First Name Of The Provider | SARAH |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1230 E MAIN ST |
| Street Address 2 Of The Provider | MANKATO CLINIC LTD |
| City Of The Provider | MANKATO |
| Zip Code Of The Provider | 560028674 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 102 |
| Number Of Services | 7028 |
| Number Of Medicare Beneficiaries | 649 |
| Total Submitted Charge Amount | 422049.76 |
| Total Medicare Allowed Amount | 84209.31 |
| Total Medicare Payment Amount | 68236.25 |
| Total Medicare Standardized Payment Amount | 68508.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 6000 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 7460 |
| Total Drug Medicare AllowedAmount | 1171.19 |
| Total Drug Medicare PaymentAmount | 918.06 |
| Total Drug Medicare Standardized Payment Amount | 918.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 100 |
| Number Of Medical Services | 1028 |
| Number Of Medicare Beneficiaries With Medical Services | 649 |
| Total Medical Submitted Charge Amount | 414589.76 |
| Total Medical Medicare Allowed Amount | 83038.12 |
| Total Medical Medicare Payment Amount | 67318.19 |
| Total Medical Medicare Standardized Payment Amount | 67590.2 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 161 |
| Number Of Beneficiaries Age 65 to 74 | 259 |
| Number Of Beneficiaries Age 75 to 84 | 157 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 458 |
| Number Of Male Beneficiaries | 191 |
| Number Of Non Hispanic White Beneficiaries | 617 |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 477 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 172 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0664 |