| National Provider Identifier [NPI]: | 1285665174 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | ANTHONY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5301 VERNON AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | EDINA |
| Zip Code Of The Provider | 554362303 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 3132 |
| Number Of Medicare Beneficiaries | 358 |
| Total Submitted Charge Amount | 189840 |
| Total Medicare Allowed Amount | 77644.66 |
| Total Medicare Payment Amount | 57025.01 |
| Total Medicare Standardized Payment Amount | 58891.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 1052 |
| Number Of Medicare Beneficiaries With Drug Services | 122 |
| Total Drug Submitted ChargeAmount | 10372 |
| Total Drug Medicare AllowedAmount | 4697.05 |
| Total Drug Medicare PaymentAmount | 4512.42 |
| Total Drug Medicare Standardized Payment Amount | 4512.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 89 |
| Number Of Medical Services | 2080 |
| Number Of Medicare Beneficiaries With Medical Services | 357 |
| Total Medical Submitted Charge Amount | 179468 |
| Total Medical Medicare Allowed Amount | 72947.61 |
| Total Medical Medicare Payment Amount | 52512.59 |
| Total Medical Medicare Standardized Payment Amount | 54378.81 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 123 |
| Number Of Beneficiaries Age 75 to 84 | 121 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 167 |
| Number Of Male Beneficiaries | 191 |
| Number Of Non Hispanic White Beneficiaries | 343 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 314 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9871 |