| National Provider Identifier [NPI]: | 1841372653 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | LEON |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2412 N OAK ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | VALDOSTA |
| Zip Code Of The Provider | 316022567 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 177 |
| Number Of Services | 13363 |
| Number Of Medicare Beneficiaries | 852 |
| Total Submitted Charge Amount | 1615712 |
| Total Medicare Allowed Amount | 465141.07 |
| Total Medicare Payment Amount | 354620.65 |
| Total Medicare Standardized Payment Amount | 379269.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 1807 |
| Number Of Medicare Beneficiaries With Drug Services | 362 |
| Total Drug Submitted ChargeAmount | 73048 |
| Total Drug Medicare AllowedAmount | 32292.31 |
| Total Drug Medicare PaymentAmount | 25628.01 |
| Total Drug Medicare Standardized Payment Amount | 25628.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 162 |
| Number Of Medical Services | 11556 |
| Number Of Medicare Beneficiaries With Medical Services | 852 |
| Total Medical Submitted Charge Amount | 1542664 |
| Total Medical Medicare Allowed Amount | 432848.76 |
| Total Medical Medicare Payment Amount | 328992.64 |
| Total Medical Medicare Standardized Payment Amount | 353641.18 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 422 |
| Number Of Beneficiaries Age 75 to 84 | 245 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 513 |
| Number Of Male Beneficiaries | 339 |
| Number Of Non Hispanic White Beneficiaries | 727 |
| Number Of Black or African American Beneficiaries | 110 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 753 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 99 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9856 |