| National Provider Identifier [NPI]: | 1013997956 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | RIPP |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 HEALTH PARK BLVD |
| Street Address 2 Of The Provider | ATTN: ST. JOHNS RADIOLOGY ASSOCIATES |
| City Of The Provider | ST AUGUSTINE |
| Zip Code Of The Provider | 320865784 |
| 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 | 264 |
| Number Of Services | 5710 |
| Number Of Medicare Beneficiaries | 2733 |
| Total Submitted Charge Amount | 950643 |
| Total Medicare Allowed Amount | 275705.73 |
| Total Medicare Payment Amount | 211980.73 |
| Total Medicare Standardized Payment Amount | 208696.79 |
| 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 | 264 |
| Number Of Medical Services | 5710 |
| Number Of Medicare Beneficiaries With Medical Services | 2733 |
| Total Medical Submitted Charge Amount | 950643 |
| Total Medical Medicare Allowed Amount | 275705.73 |
| Total Medical Medicare Payment Amount | 211980.73 |
| Total Medical Medicare Standardized Payment Amount | 208696.79 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 393 |
| Number Of Beneficiaries Age 65 to 74 | 957 |
| Number Of Beneficiaries Age 75 to 84 | 853 |
| Number Of Beneficiaries Age Greater 84 | 530 |
| Number Of Female Beneficiaries | 1482 |
| Number Of Male Beneficiaries | 1251 |
| Number Of Non Hispanic White Beneficiaries | 2368 |
| Number Of Black or African American Beneficiaries | 259 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 65 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2083 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 650 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9375 |