| National Provider Identifier [NPI]: | 1437121985 |
| Last Name Of The Provider | SMIDEBUSH |
| First Name Of The Provider | GERALD |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6001 E BROAD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432131502 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 188 |
| Number Of Services | 4096 |
| Number Of Medicare Beneficiaries | 2969 |
| Total Submitted Charge Amount | 380254.48 |
| Total Medicare Allowed Amount | 133430.12 |
| Total Medicare Payment Amount | 102466.79 |
| Total Medicare Standardized Payment Amount | 105262.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 188 |
| Number Of Medical Services | 4096 |
| Number Of Medicare Beneficiaries With Medical Services | 2969 |
| Total Medical Submitted Charge Amount | 380254.48 |
| Total Medical Medicare Allowed Amount | 133430.12 |
| Total Medical Medicare Payment Amount | 102466.79 |
| Total Medical Medicare Standardized Payment Amount | 105262.41 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 588 |
| Number Of Beneficiaries Age 65 to 74 | 1118 |
| Number Of Beneficiaries Age 75 to 84 | 822 |
| Number Of Beneficiaries Age Greater 84 | 441 |
| Number Of Female Beneficiaries | 1862 |
| Number Of Male Beneficiaries | 1107 |
| Number Of Non Hispanic White Beneficiaries | 2643 |
| Number Of Black or African American Beneficiaries | 242 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2211 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 758 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6279 |