| National Provider Identifier [NPI]: | 1396744231 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | DONNA |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1139 E HIGH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHARLOTTESVILLE |
| Zip Code Of The Provider | 229024856 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 624 |
| Number Of Medicare Beneficiaries | 478 |
| Total Submitted Charge Amount | 126505 |
| Total Medicare Allowed Amount | 56731.98 |
| Total Medicare Payment Amount | 39184.57 |
| Total Medicare Standardized Payment Amount | 48477.47 |
| 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 | 7 |
| Number Of Medical Services | 624 |
| Number Of Medicare Beneficiaries With Medical Services | 478 |
| Total Medical Submitted Charge Amount | 126505 |
| Total Medical Medicare Allowed Amount | 56731.98 |
| Total Medical Medicare Payment Amount | 39184.57 |
| Total Medical Medicare Standardized Payment Amount | 48477.47 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 215 |
| Number Of Beneficiaries Age 75 to 84 | 164 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 294 |
| Number Of Male Beneficiaries | 184 |
| Number Of Non Hispanic White Beneficiaries | 431 |
| 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 | 429 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1203 |