| National Provider Identifier [NPI]: | 1104841188 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | JEFFERY |
| 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 | 304 W HAY ST |
| Street Address 2 Of The Provider | SUITE 215 |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 625266328 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 146 |
| Number Of Services | 2229 |
| Number Of Medicare Beneficiaries | 529 |
| Total Submitted Charge Amount | 292950.19 |
| Total Medicare Allowed Amount | 239118.89 |
| Total Medicare Payment Amount | 178256.27 |
| Total Medicare Standardized Payment Amount | 190150.44 |
| 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 | 146 |
| Number Of Medical Services | 2229 |
| Number Of Medicare Beneficiaries With Medical Services | 529 |
| Total Medical Submitted Charge Amount | 292950.19 |
| Total Medical Medicare Allowed Amount | 239118.89 |
| Total Medical Medicare Payment Amount | 178256.27 |
| Total Medical Medicare Standardized Payment Amount | 190150.44 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 237 |
| Number Of Beneficiaries Age 75 to 84 | 143 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 339 |
| Number Of Male Beneficiaries | 190 |
| Number Of Non Hispanic White Beneficiaries | 490 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 433 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1904 |