National Provider Identifier [NPI]: |
1306023114 |
Last Name Of The Provider |
SMETANICK |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3010 WILLIAMS DR |
Street Address 2 Of The Provider |
SUITE 177 |
City Of The Provider |
GEORGETOWN |
Zip Code Of The Provider |
786282764 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
9471 |
Number Of Medicare Beneficiaries |
1538 |
Total Submitted Charge Amount |
969937.25 |
Total Medicare Allowed Amount |
555296.86 |
Total Medicare Payment Amount |
400878.14 |
Total Medicare Standardized Payment Amount |
422127.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
31 |
Number Of Medicare Beneficiaries With Drug Services |
21 |
Total Drug Submitted ChargeAmount |
178.25 |
Total Drug Medicare AllowedAmount |
55.4 |
Total Drug Medicare PaymentAmount |
40.58 |
Total Drug Medicare Standardized Payment Amount |
40.58 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
52 |
Number Of Medical Services |
9440 |
Number Of Medicare Beneficiaries With Medical Services |
1538 |
Total Medical Submitted Charge Amount |
969759 |
Total Medical Medicare Allowed Amount |
555241.46 |
Total Medical Medicare Payment Amount |
400837.56 |
Total Medical Medicare Standardized Payment Amount |
422086.91 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
81 |
Number Of Beneficiaries Age 65 to 74 |
729 |
Number Of Beneficiaries Age 75 to 84 |
531 |
Number Of Beneficiaries Age Greater 84 |
197 |
Number Of Female Beneficiaries |
658 |
Number Of Male Beneficiaries |
880 |
Number Of Non Hispanic White Beneficiaries |
1491 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1416 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
122 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9978 |