| National Provider Identifier [NPI]: | 1811930266 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 105 W STONE DR |
| Street Address 2 Of The Provider | STE 1F |
| City Of The Provider | KINGSPORT |
| Zip Code Of The Provider | 376603365 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 1087 |
| Number Of Medicare Beneficiaries | 333 |
| Total Submitted Charge Amount | 169824.43 |
| Total Medicare Allowed Amount | 72379.8 |
| Total Medicare Payment Amount | 55156.08 |
| Total Medicare Standardized Payment Amount | 60337.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 147 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 1993.5 |
| Total Drug Medicare AllowedAmount | 292.34 |
| Total Drug Medicare PaymentAmount | 234.27 |
| Total Drug Medicare Standardized Payment Amount | 234.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 940 |
| Number Of Medicare Beneficiaries With Medical Services | 333 |
| Total Medical Submitted Charge Amount | 167830.93 |
| Total Medical Medicare Allowed Amount | 72087.46 |
| Total Medical Medicare Payment Amount | 54921.81 |
| Total Medical Medicare Standardized Payment Amount | 60103.19 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 109 |
| Number Of Beneficiaries Age 75 to 84 | 113 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 174 |
| Number Of Male Beneficiaries | 159 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 229 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 49 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.0401 |