| National Provider Identifier [NPI]: | 1669458162 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 950 N YORK RD |
| Street Address 2 Of The Provider | SUITE 203 |
| City Of The Provider | HINSDALE |
| Zip Code Of The Provider | 605212950 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 7684 |
| Number Of Medicare Beneficiaries | 2167 |
| Total Submitted Charge Amount | 1828942.59 |
| Total Medicare Allowed Amount | 1649612.71 |
| Total Medicare Payment Amount | 1237599.93 |
| Total Medicare Standardized Payment Amount | 1195720.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1572 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 860787.5 |
| Total Drug Medicare AllowedAmount | 761336.39 |
| Total Drug Medicare PaymentAmount | 594875.63 |
| Total Drug Medicare Standardized Payment Amount | 594875.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 6112 |
| Number Of Medicare Beneficiaries With Medical Services | 2167 |
| Total Medical Submitted Charge Amount | 968155.09 |
| Total Medical Medicare Allowed Amount | 888276.32 |
| Total Medical Medicare Payment Amount | 642724.3 |
| Total Medical Medicare Standardized Payment Amount | 600845.35 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 726 |
| Number Of Beneficiaries Age 75 to 84 | 879 |
| Number Of Beneficiaries Age Greater 84 | 532 |
| Number Of Female Beneficiaries | 1335 |
| Number Of Male Beneficiaries | 832 |
| Number Of Non Hispanic White Beneficiaries | 2023 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | 52 |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 42 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2143 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9921 |