| National Provider Identifier [NPI]: | 1639288293 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | RANDEL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 415 S 28TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HATTIESBURG |
| Zip Code Of The Provider | 394017246 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 111 |
| Number Of Services | 12314 |
| Number Of Medicare Beneficiaries | 1669 |
| Total Submitted Charge Amount | 1507991 |
| Total Medicare Allowed Amount | 413023.37 |
| Total Medicare Payment Amount | 300844.45 |
| Total Medicare Standardized Payment Amount | 337225.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 7786 |
| Number Of Medicare Beneficiaries With Drug Services | 104 |
| Total Drug Submitted ChargeAmount | 10093 |
| Total Drug Medicare AllowedAmount | 2302.74 |
| Total Drug Medicare PaymentAmount | 1805.43 |
| Total Drug Medicare Standardized Payment Amount | 1805.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 106 |
| Number Of Medical Services | 4528 |
| Number Of Medicare Beneficiaries With Medical Services | 1669 |
| Total Medical Submitted Charge Amount | 1497898 |
| Total Medical Medicare Allowed Amount | 410720.63 |
| Total Medical Medicare Payment Amount | 299039.02 |
| Total Medical Medicare Standardized Payment Amount | 335420.36 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 214 |
| Number Of Beneficiaries Age 65 to 74 | 709 |
| Number Of Beneficiaries Age 75 to 84 | 541 |
| Number Of Beneficiaries Age Greater 84 | 205 |
| Number Of Female Beneficiaries | 798 |
| Number Of Male Beneficiaries | 871 |
| Number Of Non Hispanic White Beneficiaries | 1387 |
| Number Of Black or African American Beneficiaries | 266 |
| 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 | 1259 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 410 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5376 |