| National Provider Identifier [NPI]: | 1619975380 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | ALBERT |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 165 S 6TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | RAYMONDVILLE |
| Zip Code Of The Provider | 785803521 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 211 |
| Number Of Services | 14917 |
| Number Of Medicare Beneficiaries | 539 |
| Total Submitted Charge Amount | 1257155.08 |
| Total Medicare Allowed Amount | 487523.28 |
| Total Medicare Payment Amount | 375131.43 |
| Total Medicare Standardized Payment Amount | 394695.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 19 |
| Number Of Drug Services | 1931 |
| Number Of Medicare Beneficiaries With Drug Services | 360 |
| Total Drug Submitted ChargeAmount | 45765.08 |
| Total Drug Medicare AllowedAmount | 11530.98 |
| Total Drug Medicare PaymentAmount | 10673.45 |
| Total Drug Medicare Standardized Payment Amount | 10673.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 192 |
| Number Of Medical Services | 12986 |
| Number Of Medicare Beneficiaries With Medical Services | 539 |
| Total Medical Submitted Charge Amount | 1211390 |
| Total Medical Medicare Allowed Amount | 475992.3 |
| Total Medical Medicare Payment Amount | 364457.98 |
| Total Medical Medicare Standardized Payment Amount | 384021.7 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 204 |
| Number Of Beneficiaries Age 75 to 84 | 177 |
| Number Of Beneficiaries Age Greater 84 | 84 |
| Number Of Female Beneficiaries | 324 |
| Number Of Male Beneficiaries | 215 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 299 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 320 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 219 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1896 |