| National Provider Identifier [NPI]: | 1790999753 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | RANDELON |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 80 HUMPHREYS CENTER |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 38120 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 5079 |
| Number Of Medicare Beneficiaries | 882 |
| Total Submitted Charge Amount | 631581.84 |
| Total Medicare Allowed Amount | 238082.85 |
| Total Medicare Payment Amount | 183418.71 |
| Total Medicare Standardized Payment Amount | 196957.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 2360 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 2360 |
| Total Drug Medicare AllowedAmount | 447.96 |
| Total Drug Medicare PaymentAmount | 341.57 |
| Total Drug Medicare Standardized Payment Amount | 341.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 2719 |
| Number Of Medicare Beneficiaries With Medical Services | 882 |
| Total Medical Submitted Charge Amount | 629221.84 |
| Total Medical Medicare Allowed Amount | 237634.89 |
| Total Medical Medicare Payment Amount | 183077.14 |
| Total Medical Medicare Standardized Payment Amount | 196615.49 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 255 |
| Number Of Beneficiaries Age 65 to 74 | 294 |
| Number Of Beneficiaries Age 75 to 84 | 217 |
| Number Of Beneficiaries Age Greater 84 | 116 |
| Number Of Female Beneficiaries | 535 |
| Number Of Male Beneficiaries | 347 |
| Number Of Non Hispanic White Beneficiaries | 449 |
| Number Of Black or African American Beneficiaries | 414 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 510 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 372 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.6198 |