| National Provider Identifier [NPI]: | 1700214251 |
| Last Name Of The Provider | SMYTH |
| First Name Of The Provider | MICHELLE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | APRN |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6 TSIENNETO RD |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | DERRY |
| Zip Code Of The Provider | 030381584 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 562 |
| Number Of Medicare Beneficiaries | 123 |
| Total Submitted Charge Amount | 83048 |
| Total Medicare Allowed Amount | 34273.88 |
| Total Medicare Payment Amount | 25813.85 |
| Total Medicare Standardized Payment Amount | 29836.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 30 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 2251 |
| Total Drug Medicare AllowedAmount | 800.65 |
| Total Drug Medicare PaymentAmount | 784.55 |
| Total Drug Medicare Standardized Payment Amount | 784.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 532 |
| Number Of Medicare Beneficiaries With Medical Services | 123 |
| Total Medical Submitted Charge Amount | 80797 |
| Total Medical Medicare Allowed Amount | 33473.23 |
| Total Medical Medicare Payment Amount | 25029.3 |
| Total Medical Medicare Standardized Payment Amount | 29051.86 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 45 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 79 |
| Number Of Male Beneficiaries | 44 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 105 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1817 |