| National Provider Identifier [NPI]: | 1366515561 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | LANNA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1625 N GEORGE MASON DR |
| Street Address 2 Of The Provider | #414 |
| City Of The Provider | ARLINGTON |
| Zip Code Of The Provider | 222053683 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 2 |
| Number Of Services | 727 |
| Number Of Medicare Beneficiaries | 607 |
| Total Submitted Charge Amount | 43270 |
| Total Medicare Allowed Amount | 11795.57 |
| Total Medicare Payment Amount | 8491.36 |
| Total Medicare Standardized Payment Amount | 8740.46 |
| 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 | 2 |
| Number Of Medical Services | 727 |
| Number Of Medicare Beneficiaries With Medical Services | 607 |
| Total Medical Submitted Charge Amount | 43270 |
| Total Medical Medicare Allowed Amount | 11795.57 |
| Total Medical Medicare Payment Amount | 8491.36 |
| Total Medical Medicare Standardized Payment Amount | 8740.46 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 177 |
| Number Of Beneficiaries Age 75 to 84 | 241 |
| Number Of Beneficiaries Age Greater 84 | 167 |
| Number Of Female Beneficiaries | 300 |
| Number Of Male Beneficiaries | 307 |
| Number Of Non Hispanic White Beneficiaries | 496 |
| Number Of Black or African American Beneficiaries | 56 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 548 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 48 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4046 |