| National Provider Identifier [NPI]: | 1336119312 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2121 E HARMONY RD |
| Street Address 2 Of The Provider | SUITE 350 |
| City Of The Provider | FORT COLLINS |
| Zip Code Of The Provider | 805283404 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Otolaryngology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 1013 |
| Number Of Medicare Beneficiaries | 412 |
| Total Submitted Charge Amount | 128471.5 |
| Total Medicare Allowed Amount | 63342.16 |
| Total Medicare Payment Amount | 44483.48 |
| Total Medicare Standardized Payment Amount | 43987.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 15 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 150 |
| Total Drug Medicare AllowedAmount | 85.77 |
| Total Drug Medicare PaymentAmount | 59.12 |
| Total Drug Medicare Standardized Payment Amount | 59.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 998 |
| Number Of Medicare Beneficiaries With Medical Services | 412 |
| Total Medical Submitted Charge Amount | 128321.5 |
| Total Medical Medicare Allowed Amount | 63256.39 |
| Total Medical Medicare Payment Amount | 44424.36 |
| Total Medical Medicare Standardized Payment Amount | 43928.16 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 180 |
| Number Of Beneficiaries Age 75 to 84 | 139 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 224 |
| Number Of Male Beneficiaries | 188 |
| Number Of Non Hispanic White Beneficiaries | 385 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 380 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9788 |