| National Provider Identifier [NPI]: | 1841429008 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | BRYAN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4111 S DARLINGTON AVE |
| Street Address 2 Of The Provider | STE 700 |
| City Of The Provider | TULSA |
| Zip Code Of The Provider | 74135 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 147 |
| Number Of Services | 7359 |
| Number Of Medicare Beneficiaries | 4862 |
| Total Submitted Charge Amount | 574982 |
| Total Medicare Allowed Amount | 189811.37 |
| Total Medicare Payment Amount | 142575.62 |
| Total Medicare Standardized Payment Amount | 151386.02 |
| 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 | 147 |
| Number Of Medical Services | 7359 |
| Number Of Medicare Beneficiaries With Medical Services | 4862 |
| Total Medical Submitted Charge Amount | 574982 |
| Total Medical Medicare Allowed Amount | 189811.37 |
| Total Medical Medicare Payment Amount | 142575.62 |
| Total Medical Medicare Standardized Payment Amount | 151386.02 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1171 |
| Number Of Beneficiaries Age 65 to 74 | 1693 |
| Number Of Beneficiaries Age 75 to 84 | 1244 |
| Number Of Beneficiaries Age Greater 84 | 754 |
| Number Of Female Beneficiaries | 2884 |
| Number Of Male Beneficiaries | 1978 |
| Number Of Non Hispanic White Beneficiaries | 3913 |
| Number Of Black or African American Beneficiaries | 431 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 69 |
| Number Of American Indian Alaska Native Beneficiaries | 394 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3404 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1458 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.6119 |