| National Provider Identifier [NPI]: | 1508881632 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | ALICE |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4301 JONES BRIDGE RD |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY AND RADIOLOGICAL SCIENCES |
| City Of The Provider | BETHESDA |
| Zip Code Of The Provider | 208144712 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 119 |
| Number Of Services | 9787 |
| Number Of Medicare Beneficiaries | 2051 |
| Total Submitted Charge Amount | 950452.37 |
| Total Medicare Allowed Amount | 288172.12 |
| Total Medicare Payment Amount | 211353.79 |
| Total Medicare Standardized Payment Amount | 199222.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 6926 |
| Number Of Medicare Beneficiaries With Drug Services | 127 |
| Total Drug Submitted ChargeAmount | 10094.6 |
| Total Drug Medicare AllowedAmount | 3306.87 |
| Total Drug Medicare PaymentAmount | 2499.46 |
| Total Drug Medicare Standardized Payment Amount | 2499.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 116 |
| Number Of Medical Services | 2861 |
| Number Of Medicare Beneficiaries With Medical Services | 2051 |
| Total Medical Submitted Charge Amount | 940357.77 |
| Total Medical Medicare Allowed Amount | 284865.25 |
| Total Medical Medicare Payment Amount | 208854.33 |
| Total Medical Medicare Standardized Payment Amount | 196722.77 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 147 |
| Number Of Beneficiaries Age 65 to 74 | 890 |
| Number Of Beneficiaries Age 75 to 84 | 664 |
| Number Of Beneficiaries Age Greater 84 | 350 |
| Number Of Female Beneficiaries | 1281 |
| Number Of Male Beneficiaries | 770 |
| Number Of Non Hispanic White Beneficiaries | 296 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 1420 |
| Number Of Hispanic Beneficiaries | 91 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 229 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1751 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 300 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0683 |