| National Provider Identifier [NPI]: | 1952314767 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1308 PALUXY RD STE E |
| Street Address 2 Of The Provider | STE 201 |
| City Of The Provider | GRANBURY |
| Zip Code Of The Provider | 760485689 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 2152 |
| Number Of Medicare Beneficiaries | 220 |
| Total Submitted Charge Amount | 310038 |
| Total Medicare Allowed Amount | 114585.37 |
| Total Medicare Payment Amount | 77829.29 |
| Total Medicare Standardized Payment Amount | 84108.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 314 |
| Number Of Medicare Beneficiaries With Drug Services | 120 |
| Total Drug Submitted ChargeAmount | 12886 |
| Total Drug Medicare AllowedAmount | 1899.33 |
| Total Drug Medicare PaymentAmount | 1548.77 |
| Total Drug Medicare Standardized Payment Amount | 1548.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 1838 |
| Number Of Medicare Beneficiaries With Medical Services | 220 |
| Total Medical Submitted Charge Amount | 297152 |
| Total Medical Medicare Allowed Amount | 112686.04 |
| Total Medical Medicare Payment Amount | 76280.52 |
| Total Medical Medicare Standardized Payment Amount | 82559.87 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 109 |
| Number Of Beneficiaries Age 75 to 84 | 67 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 155 |
| Number Of Male Beneficiaries | 65 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 205 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8361 |