| National Provider Identifier [NPI]: | 1386619021 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9700 PARK PLAZA AVE UNIT 103 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402412286 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 1660 |
| Number Of Medicare Beneficiaries | 906 |
| Total Submitted Charge Amount | 405560 |
| Total Medicare Allowed Amount | 258741.86 |
| Total Medicare Payment Amount | 185308.12 |
| Total Medicare Standardized Payment Amount | 203149.17 |
| 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 | 27 |
| Number Of Medical Services | 1660 |
| Number Of Medicare Beneficiaries With Medical Services | 906 |
| Total Medical Submitted Charge Amount | 405560 |
| Total Medical Medicare Allowed Amount | 258741.86 |
| Total Medical Medicare Payment Amount | 185308.12 |
| Total Medical Medicare Standardized Payment Amount | 203149.17 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 423 |
| Number Of Beneficiaries Age 75 to 84 | 333 |
| Number Of Beneficiaries Age Greater 84 | 128 |
| Number Of Female Beneficiaries | 550 |
| Number Of Male Beneficiaries | 356 |
| Number Of Non Hispanic White Beneficiaries | 873 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 890 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9049 |