| National Provider Identifier [NPI]: | 1306870662 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | CLINTON |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 620 CROSSOVER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUPELO |
| Zip Code Of The Provider | 388014944 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 309 |
| Number Of Services | 17883 |
| Number Of Medicare Beneficiaries | 3740 |
| Total Submitted Charge Amount | 1668962.21 |
| Total Medicare Allowed Amount | 423732.53 |
| Total Medicare Payment Amount | 323645.43 |
| Total Medicare Standardized Payment Amount | 351419.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 11711 |
| Number Of Medicare Beneficiaries With Drug Services | 127 |
| Total Drug Submitted ChargeAmount | 12810.42 |
| Total Drug Medicare AllowedAmount | 2561.21 |
| Total Drug Medicare PaymentAmount | 1979.01 |
| Total Drug Medicare Standardized Payment Amount | 1979.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 306 |
| Number Of Medical Services | 6172 |
| Number Of Medicare Beneficiaries With Medical Services | 3739 |
| Total Medical Submitted Charge Amount | 1656151.79 |
| Total Medical Medicare Allowed Amount | 421171.32 |
| Total Medical Medicare Payment Amount | 321666.42 |
| Total Medical Medicare Standardized Payment Amount | 349440.6 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 948 |
| Number Of Beneficiaries Age 65 to 74 | 1297 |
| Number Of Beneficiaries Age 75 to 84 | 1037 |
| Number Of Beneficiaries Age Greater 84 | 458 |
| Number Of Female Beneficiaries | 2123 |
| Number Of Male Beneficiaries | 1617 |
| Number Of Non Hispanic White Beneficiaries | 3016 |
| Number Of Black or African American Beneficiaries | 690 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2225 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1515 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.76 |