| National Provider Identifier [NPI]: | 1932174885 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4516 N ARMENIA AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336032732 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 152 |
| Number Of Services | 5757 |
| Number Of Medicare Beneficiaries | 1634 |
| Total Submitted Charge Amount | 502177.6 |
| Total Medicare Allowed Amount | 133742.34 |
| Total Medicare Payment Amount | 99710.34 |
| Total Medicare Standardized Payment Amount | 102017.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3695 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 8820.6 |
| Total Drug Medicare AllowedAmount | 969.99 |
| Total Drug Medicare PaymentAmount | 746.8 |
| Total Drug Medicare Standardized Payment Amount | 746.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 149 |
| Number Of Medical Services | 2062 |
| Number Of Medicare Beneficiaries With Medical Services | 1634 |
| Total Medical Submitted Charge Amount | 493357 |
| Total Medical Medicare Allowed Amount | 132772.35 |
| Total Medical Medicare Payment Amount | 98963.54 |
| Total Medical Medicare Standardized Payment Amount | 101270.85 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 269 |
| Number Of Beneficiaries Age 65 to 74 | 531 |
| Number Of Beneficiaries Age 75 to 84 | 504 |
| Number Of Beneficiaries Age Greater 84 | 330 |
| Number Of Female Beneficiaries | 981 |
| Number Of Male Beneficiaries | 653 |
| Number Of Non Hispanic White Beneficiaries | 1058 |
| Number Of Black or African American Beneficiaries | 202 |
| Number Of AsianPacific Islander Beneficiaries | 19 |
| Number Of Hispanic Beneficiaries | 339 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1086 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 548 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.03 |