| National Provider Identifier [NPI]: | 1508868464 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1250 S 18TH ST |
| Street Address 2 Of The Provider | SUITE 204 |
| City Of The Provider | FERNANDINA BEACH |
| Zip Code Of The Provider | 320341902 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 4212 |
| Number Of Medicare Beneficiaries | 624 |
| Total Submitted Charge Amount | 704528.26 |
| Total Medicare Allowed Amount | 311272.11 |
| Total Medicare Payment Amount | 230875.61 |
| Total Medicare Standardized Payment Amount | 232394.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1441 |
| Number Of Medicare Beneficiaries With Drug Services | 283 |
| Total Drug Submitted ChargeAmount | 130345.26 |
| Total Drug Medicare AllowedAmount | 49923.31 |
| Total Drug Medicare PaymentAmount | 38027.9 |
| Total Drug Medicare Standardized Payment Amount | 38027.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 2771 |
| Number Of Medicare Beneficiaries With Medical Services | 624 |
| Total Medical Submitted Charge Amount | 574183 |
| Total Medical Medicare Allowed Amount | 261348.8 |
| Total Medical Medicare Payment Amount | 192847.71 |
| Total Medical Medicare Standardized Payment Amount | 194366.59 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 297 |
| Number Of Beneficiaries Age 75 to 84 | 197 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 376 |
| Number Of Male Beneficiaries | 248 |
| Number Of Non Hispanic White Beneficiaries | 582 |
| Number Of Black or African American Beneficiaries | 21 |
| 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 | 572 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.0545 |