| National Provider Identifier [NPI]: | 1417910720 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1449 E BERT KOUNS INDUSTRIAL LOOP |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | SHREVEPORT |
| Zip Code Of The Provider | 711055634 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 5821 |
| Number Of Medicare Beneficiaries | 842 |
| Total Submitted Charge Amount | 460194.76 |
| Total Medicare Allowed Amount | 365326.21 |
| Total Medicare Payment Amount | 273428.07 |
| Total Medicare Standardized Payment Amount | 262548.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 1145 |
| Number Of Medicare Beneficiaries With Drug Services | 240 |
| Total Drug Submitted ChargeAmount | 10595.5 |
| Total Drug Medicare AllowedAmount | 5092.55 |
| Total Drug Medicare PaymentAmount | 4936.7 |
| Total Drug Medicare Standardized Payment Amount | 4936.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 4676 |
| Number Of Medicare Beneficiaries With Medical Services | 842 |
| Total Medical Submitted Charge Amount | 449599.26 |
| Total Medical Medicare Allowed Amount | 360233.66 |
| Total Medical Medicare Payment Amount | 268491.37 |
| Total Medical Medicare Standardized Payment Amount | 257612.2 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 318 |
| Number Of Beneficiaries Age 75 to 84 | 322 |
| Number Of Beneficiaries Age Greater 84 | 162 |
| Number Of Female Beneficiaries | 493 |
| Number Of Male Beneficiaries | 349 |
| Number Of Non Hispanic White Beneficiaries | 717 |
| Number Of Black or African American Beneficiaries | 108 |
| 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 | 761 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4583 |