| National Provider Identifier [NPI]: | 1194704312 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | JACQUELINE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2521 GLENN HENDREN DR |
| Street Address 2 Of The Provider | SUITE 402 |
| City Of The Provider | LIBERTY |
| Zip Code Of The Provider | 640683388 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 4227 |
| Number Of Medicare Beneficiaries | 828 |
| Total Submitted Charge Amount | 408227 |
| Total Medicare Allowed Amount | 301583.1 |
| Total Medicare Payment Amount | 231784.76 |
| Total Medicare Standardized Payment Amount | 234374.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 876 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 26947 |
| Total Drug Medicare AllowedAmount | 23506.69 |
| Total Drug Medicare PaymentAmount | 18686.37 |
| Total Drug Medicare Standardized Payment Amount | 18686.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 3351 |
| Number Of Medicare Beneficiaries With Medical Services | 828 |
| Total Medical Submitted Charge Amount | 381280 |
| Total Medical Medicare Allowed Amount | 278076.41 |
| Total Medical Medicare Payment Amount | 213098.39 |
| Total Medical Medicare Standardized Payment Amount | 215688.2 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 133 |
| Number Of Beneficiaries Age 65 to 74 | 339 |
| Number Of Beneficiaries Age 75 to 84 | 262 |
| Number Of Beneficiaries Age Greater 84 | 94 |
| Number Of Female Beneficiaries | 448 |
| Number Of Male Beneficiaries | 380 |
| Number Of Non Hispanic White Beneficiaries | 788 |
| Number Of Black or African American Beneficiaries | 16 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 693 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 135 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 22 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 60 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.8984 |