| National Provider Identifier [NPI]: | 1558305490 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | ELLEN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 901 W 38TH ST |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787051165 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gynecological/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 144 |
| Number Of Services | 27511 |
| Number Of Medicare Beneficiaries | 215 |
| Total Submitted Charge Amount | 1676355 |
| Total Medicare Allowed Amount | 396018.36 |
| Total Medicare Payment Amount | 309308.38 |
| Total Medicare Standardized Payment Amount | 307915.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 35 |
| Number Of Drug Services | 24475 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 1025181 |
| Total Drug Medicare AllowedAmount | 225325.45 |
| Total Drug Medicare PaymentAmount | 176520.79 |
| Total Drug Medicare Standardized Payment Amount | 176520.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 3036 |
| Number Of Medicare Beneficiaries With Medical Services | 215 |
| Total Medical Submitted Charge Amount | 651174 |
| Total Medical Medicare Allowed Amount | 170692.91 |
| Total Medical Medicare Payment Amount | 132787.59 |
| Total Medical Medicare Standardized Payment Amount | 131394.69 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 116 |
| Number Of Beneficiaries Age 75 to 84 | 68 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 182 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 189 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5097 |