| National Provider Identifier [NPI]: | 1356468284 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2930 SQUALICUM PKWY |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | BELLINGHAM |
| Zip Code Of The Provider | 982251854 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 192 |
| Number Of Services | 26693 |
| Number Of Medicare Beneficiaries | 3036 |
| Total Submitted Charge Amount | 1981622.6 |
| Total Medicare Allowed Amount | 378549.63 |
| Total Medicare Payment Amount | 293510.3 |
| Total Medicare Standardized Payment Amount | 298243.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 21886 |
| Number Of Medicare Beneficiaries With Drug Services | 237 |
| Total Drug Submitted ChargeAmount | 23982.6 |
| Total Drug Medicare AllowedAmount | 5074.37 |
| Total Drug Medicare PaymentAmount | 3967.53 |
| Total Drug Medicare Standardized Payment Amount | 3967.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 188 |
| Number Of Medical Services | 4807 |
| Number Of Medicare Beneficiaries With Medical Services | 3035 |
| Total Medical Submitted Charge Amount | 1957640 |
| Total Medical Medicare Allowed Amount | 373475.26 |
| Total Medical Medicare Payment Amount | 289542.77 |
| Total Medical Medicare Standardized Payment Amount | 294275.69 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 475 |
| Number Of Beneficiaries Age 65 to 74 | 1244 |
| Number Of Beneficiaries Age 75 to 84 | 884 |
| Number Of Beneficiaries Age Greater 84 | 433 |
| Number Of Female Beneficiaries | 1847 |
| Number Of Male Beneficiaries | 1189 |
| Number Of Non Hispanic White Beneficiaries | 2710 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | 68 |
| Number Of Hispanic Beneficiaries | 83 |
| Number Of American Indian Alaska Native Beneficiaries | 98 |
| Number Of Beneficiaries With Race Not Else where Classified | 55 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2317 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 719 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2887 |