| National Provider Identifier [NPI]: | 1144217803 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 W CRAWFORD AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MONTEREY |
| Zip Code Of The Provider | 38574 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 6008 |
| Number Of Medicare Beneficiaries | 545 |
| Total Submitted Charge Amount | 350218 |
| Total Medicare Allowed Amount | 203204.54 |
| Total Medicare Payment Amount | 136620.35 |
| Total Medicare Standardized Payment Amount | 149282.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 255 |
| Number Of Medicare Beneficiaries With Drug Services | 189 |
| Total Drug Submitted ChargeAmount | 5164 |
| Total Drug Medicare AllowedAmount | 3526.33 |
| Total Drug Medicare PaymentAmount | 3188.68 |
| Total Drug Medicare Standardized Payment Amount | 3188.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 5753 |
| Number Of Medicare Beneficiaries With Medical Services | 545 |
| Total Medical Submitted Charge Amount | 345054 |
| Total Medical Medicare Allowed Amount | 199678.21 |
| Total Medical Medicare Payment Amount | 133431.67 |
| Total Medical Medicare Standardized Payment Amount | 146093.93 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 231 |
| Number Of Beneficiaries Age 75 to 84 | 179 |
| Number Of Beneficiaries Age Greater 84 | 56 |
| Number Of Female Beneficiaries | 289 |
| Number Of Male Beneficiaries | 256 |
| Number Of Non Hispanic White Beneficiaries | 533 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 435 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 110 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9861 |