| National Provider Identifier [NPI]: | 1871570630 |
| Last Name Of The Provider | SMICK |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 325 N COMMERCIAL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEENAH |
| Zip Code Of The Provider | 549562665 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 179 |
| Number Of Services | 2842 |
| Number Of Medicare Beneficiaries | 2002 |
| Total Submitted Charge Amount | 674290.38 |
| Total Medicare Allowed Amount | 85282.72 |
| Total Medicare Payment Amount | 64336.5 |
| Total Medicare Standardized Payment Amount | 67723.01 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 390 |
| Number Of Beneficiaries Age 65 to 74 | 687 |
| Number Of Beneficiaries Age 75 to 84 | 561 |
| Number Of Beneficiaries Age Greater 84 | 364 |
| Number Of Female Beneficiaries | 1181 |
| Number Of Male Beneficiaries | 821 |
| Number Of Non Hispanic White Beneficiaries | 1904 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1415 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 587 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4371 |