| National Provider Identifier [NPI]: | 1902192099 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | DIANE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 901 SW GARFIELD AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TOPEKA |
| Zip Code Of The Provider | 666061670 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 1756 |
| Number Of Medicare Beneficiaries | 718 |
| Total Submitted Charge Amount | 135076.45 |
| Total Medicare Allowed Amount | 80888.18 |
| Total Medicare Payment Amount | 52989.14 |
| Total Medicare Standardized Payment Amount | 68411.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 1972.25 |
| Total Drug Medicare AllowedAmount | 1846.86 |
| Total Drug Medicare PaymentAmount | 1797.15 |
| Total Drug Medicare Standardized Payment Amount | 1797.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 1738 |
| Number Of Medicare Beneficiaries With Medical Services | 718 |
| Total Medical Submitted Charge Amount | 133104.2 |
| Total Medical Medicare Allowed Amount | 79041.32 |
| Total Medical Medicare Payment Amount | 51191.99 |
| Total Medical Medicare Standardized Payment Amount | 66614.37 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 81 |
| Number Of Beneficiaries Age 65 to 74 | 244 |
| Number Of Beneficiaries Age 75 to 84 | 248 |
| Number Of Beneficiaries Age Greater 84 | 145 |
| Number Of Female Beneficiaries | 432 |
| Number Of Male Beneficiaries | 286 |
| Number Of Non Hispanic White Beneficiaries | 654 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 644 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 74 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0484 |