| National Provider Identifier [NPI]: | 1376559849 |
| Last Name Of The Provider | SMAIL |
| First Name Of The Provider | JULIE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M D |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 36 ESSEX RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | IPSWICH |
| Zip Code Of The Provider | 019382599 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 841 |
| Number Of Medicare Beneficiaries | 79 |
| Total Submitted Charge Amount | 94856.75 |
| Total Medicare Allowed Amount | 40275.53 |
| Total Medicare Payment Amount | 29512.46 |
| Total Medicare Standardized Payment Amount | 28750.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 108 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 5252.75 |
| Total Drug Medicare AllowedAmount | 3186.87 |
| Total Drug Medicare PaymentAmount | 3074.98 |
| Total Drug Medicare Standardized Payment Amount | 3074.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 733 |
| Number Of Medicare Beneficiaries With Medical Services | 79 |
| Total Medical Submitted Charge Amount | 89604 |
| Total Medical Medicare Allowed Amount | 37088.66 |
| Total Medical Medicare Payment Amount | 26437.48 |
| Total Medical Medicare Standardized Payment Amount | 25675.18 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 42 |
| Number Of Beneficiaries Age 75 to 84 | 17 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 65 |
| Number Of Male Beneficiaries | 14 |
| Number Of Non Hispanic White Beneficiaries | 79 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 68 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1764 |