| National Provider Identifier [NPI]: | 1710970132 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | RANDOLPH |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3300 W ANDERSON LN |
| Street Address 2 Of The Provider | #308 |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787571023 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 2445 |
| Number Of Medicare Beneficiaries | 857 |
| Total Submitted Charge Amount | 631784.06 |
| Total Medicare Allowed Amount | 377752.06 |
| Total Medicare Payment Amount | 272007.96 |
| Total Medicare Standardized Payment Amount | 276139.47 |
| 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 | 25 |
| Number Of Medical Services | 2445 |
| Number Of Medicare Beneficiaries With Medical Services | 857 |
| Total Medical Submitted Charge Amount | 631784.06 |
| Total Medical Medicare Allowed Amount | 377752.06 |
| Total Medical Medicare Payment Amount | 272007.96 |
| Total Medical Medicare Standardized Payment Amount | 276139.47 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 414 |
| Number Of Beneficiaries Age 75 to 84 | 307 |
| Number Of Beneficiaries Age Greater 84 | 117 |
| Number Of Female Beneficiaries | 538 |
| Number Of Male Beneficiaries | 319 |
| Number Of Non Hispanic White Beneficiaries | 773 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 833 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.854 |