| National Provider Identifier [NPI]: | 1629057427 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1017 DELAWARE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MCCOMB |
| Zip Code Of The Provider | 396483827 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 1924 |
| Number Of Medicare Beneficiaries | 937 |
| Total Submitted Charge Amount | 888742.34 |
| Total Medicare Allowed Amount | 155193.16 |
| Total Medicare Payment Amount | 115302.7 |
| Total Medicare Standardized Payment Amount | 122806.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 355 |
| Number Of Medicare Beneficiaries With Drug Services | 106 |
| Total Drug Submitted ChargeAmount | 3935.2 |
| Total Drug Medicare AllowedAmount | 694.35 |
| Total Drug Medicare PaymentAmount | 451.11 |
| Total Drug Medicare Standardized Payment Amount | 451.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 1569 |
| Number Of Medicare Beneficiaries With Medical Services | 937 |
| Total Medical Submitted Charge Amount | 884807.14 |
| Total Medical Medicare Allowed Amount | 154498.81 |
| Total Medical Medicare Payment Amount | 114851.59 |
| Total Medical Medicare Standardized Payment Amount | 122354.91 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 234 |
| Number Of Beneficiaries Age 65 to 74 | 323 |
| Number Of Beneficiaries Age 75 to 84 | 263 |
| Number Of Beneficiaries Age Greater 84 | 117 |
| Number Of Female Beneficiaries | 529 |
| Number Of Male Beneficiaries | 408 |
| Number Of Non Hispanic White Beneficiaries | 602 |
| 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 | 549 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 388 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6096 |