| National Provider Identifier [NPI]: | 1629011564 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2777 MILE HIGH STADIUM CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | DENVER |
| Zip Code Of The Provider | 802115222 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 140 |
| Number Of Services | 18281 |
| Number Of Medicare Beneficiaries | 579 |
| Total Submitted Charge Amount | 871684.63 |
| Total Medicare Allowed Amount | 417749.01 |
| Total Medicare Payment Amount | 323127.95 |
| Total Medicare Standardized Payment Amount | 322450.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 19 |
| Number Of Drug Services | 13757 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 237740.13 |
| Total Drug Medicare AllowedAmount | 164111.73 |
| Total Drug Medicare PaymentAmount | 128094.21 |
| Total Drug Medicare Standardized Payment Amount | 128094.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 121 |
| Number Of Medical Services | 4524 |
| Number Of Medicare Beneficiaries With Medical Services | 579 |
| Total Medical Submitted Charge Amount | 633944.5 |
| Total Medical Medicare Allowed Amount | 253637.28 |
| Total Medical Medicare Payment Amount | 195033.74 |
| Total Medical Medicare Standardized Payment Amount | 194355.86 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 236 |
| Number Of Beneficiaries Age 75 to 84 | 207 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 109 |
| Number Of Male Beneficiaries | 470 |
| Number Of Non Hispanic White Beneficiaries | 528 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 538 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2754 |