| National Provider Identifier [NPI]: | 1558353698 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | CYNTHIA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7250 FRANCE AVE S |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | EDINA |
| Zip Code Of The Provider | 554354305 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 925 |
| Number Of Medicare Beneficiaries | 164 |
| Total Submitted Charge Amount | 94243 |
| Total Medicare Allowed Amount | 40583.55 |
| Total Medicare Payment Amount | 31454.15 |
| Total Medicare Standardized Payment Amount | 31948.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 61 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 4966 |
| Total Drug Medicare AllowedAmount | 2073.37 |
| Total Drug Medicare PaymentAmount | 1740.44 |
| Total Drug Medicare Standardized Payment Amount | 1740.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 864 |
| Number Of Medicare Beneficiaries With Medical Services | 164 |
| Total Medical Submitted Charge Amount | 89277 |
| Total Medical Medicare Allowed Amount | 38510.18 |
| Total Medical Medicare Payment Amount | 29713.71 |
| Total Medical Medicare Standardized Payment Amount | 30207.61 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 68 |
| Number Of Beneficiaries Age 75 to 84 | 61 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 149 |
| Number Of Male Beneficiaries | 15 |
| 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 | 12 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 10 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8121 |