National Provider Identifier [NPI]: |
1083682108 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3501 WE KNIGHT DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT SMITH |
Zip Code Of The Provider |
729036248 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
117 |
Number Of Services |
2271 |
Number Of Medicare Beneficiaries |
425 |
Total Submitted Charge Amount |
602781 |
Total Medicare Allowed Amount |
246148.15 |
Total Medicare Payment Amount |
187279.6 |
Total Medicare Standardized Payment Amount |
208285.6 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
780 |
Number Of Medicare Beneficiaries With Drug Services |
129 |
Total Drug Submitted ChargeAmount |
15092 |
Total Drug Medicare AllowedAmount |
7069.5 |
Total Drug Medicare PaymentAmount |
5415.41 |
Total Drug Medicare Standardized Payment Amount |
5415.41 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
114 |
Number Of Medical Services |
1491 |
Number Of Medicare Beneficiaries With Medical Services |
424 |
Total Medical Submitted Charge Amount |
587689 |
Total Medical Medicare Allowed Amount |
239078.65 |
Total Medical Medicare Payment Amount |
181864.19 |
Total Medical Medicare Standardized Payment Amount |
202870.19 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
136 |
Number Of Beneficiaries Age 65 to 74 |
188 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
253 |
Number Of Male Beneficiaries |
172 |
Number Of Non Hispanic White Beneficiaries |
285 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
123 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
300 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1123 |