| National Provider Identifier [NPI]: | 1679781140 |
| Last Name Of The Provider | CLARK |
| First Name Of The Provider | RANDY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1490 E FOREMASTER DR |
| Street Address 2 Of The Provider | SUITE 150 |
| City Of The Provider | ST GEORGE |
| Zip Code Of The Provider | 847904488 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 187 |
| Number Of Services | 5116 |
| Number Of Medicare Beneficiaries | 523 |
| Total Submitted Charge Amount | 853453 |
| Total Medicare Allowed Amount | 334926.61 |
| Total Medicare Payment Amount | 257946.13 |
| Total Medicare Standardized Payment Amount | 265994.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 3102 |
| Number Of Medicare Beneficiaries With Drug Services | 177 |
| Total Drug Submitted ChargeAmount | 77729 |
| Total Drug Medicare AllowedAmount | 33279.13 |
| Total Drug Medicare PaymentAmount | 26062.82 |
| Total Drug Medicare Standardized Payment Amount | 26062.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 181 |
| Number Of Medical Services | 2014 |
| Number Of Medicare Beneficiaries With Medical Services | 523 |
| Total Medical Submitted Charge Amount | 775724 |
| Total Medical Medicare Allowed Amount | 301647.48 |
| Total Medical Medicare Payment Amount | 231883.31 |
| Total Medical Medicare Standardized Payment Amount | 239931.29 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 245 |
| Number Of Beneficiaries Age 75 to 84 | 150 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 292 |
| Number Of Male Beneficiaries | 231 |
| Number Of Non Hispanic White Beneficiaries | 500 |
| 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 | 474 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2026 |