| National Provider Identifier [NPI]: | 1003881061 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | BILL |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1200 PINEVILLE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHATTANOOGA |
| Zip Code Of The Provider | 374052645 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 2617 |
| Number Of Medicare Beneficiaries | 259 |
| Total Submitted Charge Amount | 247086.25 |
| Total Medicare Allowed Amount | 149667.77 |
| Total Medicare Payment Amount | 108982.09 |
| Total Medicare Standardized Payment Amount | 117820.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 930 |
| Number Of Medicare Beneficiaries With Drug Services | 107 |
| Total Drug Submitted ChargeAmount | 14790.25 |
| Total Drug Medicare AllowedAmount | 4677.4 |
| Total Drug Medicare PaymentAmount | 3650.53 |
| Total Drug Medicare Standardized Payment Amount | 3650.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 1687 |
| Number Of Medicare Beneficiaries With Medical Services | 259 |
| Total Medical Submitted Charge Amount | 232296 |
| Total Medical Medicare Allowed Amount | 144990.37 |
| Total Medical Medicare Payment Amount | 105331.56 |
| Total Medical Medicare Standardized Payment Amount | 114169.68 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 146 |
| Number Of Beneficiaries Age 75 to 84 | 83 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 107 |
| Number Of Male Beneficiaries | 152 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.8234 |