| National Provider Identifier [NPI]: | 1972571842 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | GEOFFREY |
| 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 | 419 S WASHINGTON ST |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | CASPER |
| Zip Code Of The Provider | 826012951 |
| State Code Of The Provider | WY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 350 |
| Number Of Services | 113302 |
| Number Of Medicare Beneficiaries | 5633 |
| Total Submitted Charge Amount | 7981696.57 |
| Total Medicare Allowed Amount | 1245942.89 |
| Total Medicare Payment Amount | 969228.23 |
| Total Medicare Standardized Payment Amount | 976827.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 98472 |
| Number Of Medicare Beneficiaries With Drug Services | 1062 |
| Total Drug Submitted ChargeAmount | 241244.85 |
| Total Drug Medicare AllowedAmount | 33125.85 |
| Total Drug Medicare PaymentAmount | 25727.73 |
| Total Drug Medicare Standardized Payment Amount | 25727.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 336 |
| Number Of Medical Services | 14830 |
| Number Of Medicare Beneficiaries With Medical Services | 5630 |
| Total Medical Submitted Charge Amount | 7740451.72 |
| Total Medical Medicare Allowed Amount | 1212817.04 |
| Total Medical Medicare Payment Amount | 943500.5 |
| Total Medical Medicare Standardized Payment Amount | 951100.22 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 764 |
| Number Of Beneficiaries Age 65 to 74 | 2494 |
| Number Of Beneficiaries Age 75 to 84 | 1699 |
| Number Of Beneficiaries Age Greater 84 | 676 |
| Number Of Female Beneficiaries | 3700 |
| Number Of Male Beneficiaries | 1933 |
| Number Of Non Hispanic White Beneficiaries | 5293 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 169 |
| Number Of American Indian Alaska Native Beneficiaries | 63 |
| Number Of Beneficiaries With Race Not Else where Classified | 64 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4721 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 912 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1366 |