National Provider Identifier [NPI]: |
1831268044 |
Last Name Of The Provider |
SMID |
First Name Of The Provider |
DAVID |
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 |
1000 E PRIMROSE ST STE 550 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658075180 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
4543 |
Number Of Medicare Beneficiaries |
2001 |
Total Submitted Charge Amount |
441125.45 |
Total Medicare Allowed Amount |
151574.21 |
Total Medicare Payment Amount |
108385.65 |
Total Medicare Standardized Payment Amount |
83791.21 |
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 |
26 |
Number Of Medical Services |
4543 |
Number Of Medicare Beneficiaries With Medical Services |
2001 |
Total Medical Submitted Charge Amount |
441125.45 |
Total Medical Medicare Allowed Amount |
151574.21 |
Total Medical Medicare Payment Amount |
108385.65 |
Total Medical Medicare Standardized Payment Amount |
83791.21 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
249 |
Number Of Beneficiaries Age 65 to 74 |
900 |
Number Of Beneficiaries Age 75 to 84 |
614 |
Number Of Beneficiaries Age Greater 84 |
238 |
Number Of Female Beneficiaries |
1023 |
Number Of Male Beneficiaries |
978 |
Number Of Non Hispanic White Beneficiaries |
1954 |
Number Of Black or African American Beneficiaries |
12 |
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 |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
1764 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
237 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.1715 |