| National Provider Identifier [NPI]: | 1437157260 |
| Last Name Of The Provider | CLARKE |
| First Name Of The Provider | STACEY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1408 N HALL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LA GRANDE |
| Zip Code Of The Provider | 978503807 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 4316 |
| Number Of Medicare Beneficiaries | 949 |
| Total Submitted Charge Amount | 281765.62 |
| Total Medicare Allowed Amount | 247677.29 |
| Total Medicare Payment Amount | 172201.63 |
| Total Medicare Standardized Payment Amount | 184723.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 219 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 907.13 |
| Total Drug Medicare AllowedAmount | 897.43 |
| Total Drug Medicare PaymentAmount | 630.05 |
| Total Drug Medicare Standardized Payment Amount | 630.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 4097 |
| Number Of Medicare Beneficiaries With Medical Services | 949 |
| Total Medical Submitted Charge Amount | 280858.49 |
| Total Medical Medicare Allowed Amount | 246779.86 |
| Total Medical Medicare Payment Amount | 171571.58 |
| Total Medical Medicare Standardized Payment Amount | 184093.83 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 403 |
| Number Of Beneficiaries Age 75 to 84 | 328 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 569 |
| Number Of Male Beneficiaries | 380 |
| Number Of Non Hispanic White Beneficiaries | 920 |
| 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 | 846 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 103 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1267 |