| National Provider Identifier [NPI]: | 1972589927 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3000 COLISEUM DR |
| Street Address 2 Of The Provider | SENTARA CAREPLEX HOSPITAL |
| City Of The Provider | HAMPTON |
| Zip Code Of The Provider | 236665963 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 188 |
| Number Of Services | 5769 |
| Number Of Medicare Beneficiaries | 3484 |
| Total Submitted Charge Amount | 536343 |
| Total Medicare Allowed Amount | 161352.19 |
| Total Medicare Payment Amount | 128145.71 |
| Total Medicare Standardized Payment Amount | 131479.53 |
| 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 | 188 |
| Number Of Medical Services | 5769 |
| Number Of Medicare Beneficiaries With Medical Services | 3484 |
| Total Medical Submitted Charge Amount | 536343 |
| Total Medical Medicare Allowed Amount | 161352.19 |
| Total Medical Medicare Payment Amount | 128145.71 |
| Total Medical Medicare Standardized Payment Amount | 131479.53 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 347 |
| Number Of Beneficiaries Age 65 to 74 | 1572 |
| Number Of Beneficiaries Age 75 to 84 | 1090 |
| Number Of Beneficiaries Age Greater 84 | 475 |
| Number Of Female Beneficiaries | 2625 |
| Number Of Male Beneficiaries | 859 |
| Number Of Non Hispanic White Beneficiaries | 2549 |
| Number Of Black or African American Beneficiaries | 821 |
| Number Of AsianPacific Islander Beneficiaries | 30 |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 42 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3090 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 394 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3468 |