| National Provider Identifier [NPI]: | 1417925280 |
| Last Name Of The Provider | CLAGUE |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 HEALTH CIR |
| Street Address 2 Of The Provider | CARILION STONEWALL JACKSON HOSPITAL, RADIOLOGY DEPT |
| City Of The Provider | LEXINGTON |
| Zip Code Of The Provider | 244502448 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 133 |
| Number Of Services | 2173 |
| Number Of Medicare Beneficiaries | 1214 |
| Total Submitted Charge Amount | 138786.95 |
| Total Medicare Allowed Amount | 56473.83 |
| Total Medicare Payment Amount | 43540.67 |
| Total Medicare Standardized Payment Amount | 44657.7 |
| 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 | 133 |
| Number Of Medical Services | 2173 |
| Number Of Medicare Beneficiaries With Medical Services | 1214 |
| Total Medical Submitted Charge Amount | 138786.95 |
| Total Medical Medicare Allowed Amount | 56473.83 |
| Total Medical Medicare Payment Amount | 43540.67 |
| Total Medical Medicare Standardized Payment Amount | 44657.7 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 159 |
| Number Of Beneficiaries Age 65 to 74 | 427 |
| Number Of Beneficiaries Age 75 to 84 | 415 |
| Number Of Beneficiaries Age Greater 84 | 213 |
| Number Of Female Beneficiaries | 814 |
| Number Of Male Beneficiaries | 400 |
| Number Of Non Hispanic White Beneficiaries | 1130 |
| Number Of Black or African American Beneficiaries | 67 |
| 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 | 914 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 300 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2693 |