| National Provider Identifier [NPI]: | 1316264187 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | TANISHA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7762 SHALIMAR ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MIRAMAR |
| Zip Code Of The Provider | 330232426 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 11387 |
| Number Of Medicare Beneficiaries | 2805 |
| Total Submitted Charge Amount | 875831.66 |
| Total Medicare Allowed Amount | 746902.37 |
| Total Medicare Payment Amount | 533054.56 |
| Total Medicare Standardized Payment Amount | 566729.08 |
| 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 | 28 |
| Number Of Medical Services | 11387 |
| Number Of Medicare Beneficiaries With Medical Services | 2805 |
| Total Medical Submitted Charge Amount | 875831.66 |
| Total Medical Medicare Allowed Amount | 746902.37 |
| Total Medical Medicare Payment Amount | 533054.56 |
| Total Medical Medicare Standardized Payment Amount | 566729.08 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 351 |
| Number Of Beneficiaries Age 65 to 74 | 448 |
| Number Of Beneficiaries Age 75 to 84 | 720 |
| Number Of Beneficiaries Age Greater 84 | 1286 |
| Number Of Female Beneficiaries | 1910 |
| Number Of Male Beneficiaries | 895 |
| Number Of Non Hispanic White Beneficiaries | 2344 |
| Number Of Black or African American Beneficiaries | 412 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 712 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2093 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 73 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 52 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 28 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.3254 |