National Provider Identifier [NPI]: |
1285645945 |
Last Name Of The Provider |
SMOOTS |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1608 S J ST |
Street Address 2 Of The Provider |
FLOOR 3 |
City Of The Provider |
TACOMA |
Zip Code Of The Provider |
984054930 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
93 |
Number Of Services |
6238 |
Number Of Medicare Beneficiaries |
602 |
Total Submitted Charge Amount |
667452 |
Total Medicare Allowed Amount |
249351.3 |
Total Medicare Payment Amount |
180807.46 |
Total Medicare Standardized Payment Amount |
181936.81 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
22 |
Number Of Drug Services |
2652 |
Number Of Medicare Beneficiaries With Drug Services |
259 |
Total Drug Submitted ChargeAmount |
82894 |
Total Drug Medicare AllowedAmount |
31100.68 |
Total Drug Medicare PaymentAmount |
24453.1 |
Total Drug Medicare Standardized Payment Amount |
24453.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
71 |
Number Of Medical Services |
3586 |
Number Of Medicare Beneficiaries With Medical Services |
602 |
Total Medical Submitted Charge Amount |
584558 |
Total Medical Medicare Allowed Amount |
218250.62 |
Total Medical Medicare Payment Amount |
156354.36 |
Total Medical Medicare Standardized Payment Amount |
157483.71 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
251 |
Number Of Beneficiaries Age 75 to 84 |
186 |
Number Of Beneficiaries Age Greater 84 |
116 |
Number Of Female Beneficiaries |
332 |
Number Of Male Beneficiaries |
270 |
Number Of Non Hispanic White Beneficiaries |
563 |
Number Of Black or African American Beneficiaries |
18 |
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 |
534 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
68 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
24 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.1261 |