| National Provider Identifier [NPI]: | 1578624813 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | KRIS |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 792 S US HIGHWAY 1 |
| Street Address 2 Of The Provider | |
| City Of The Provider | VERO BEACH |
| Zip Code Of The Provider | 329624701 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 478 |
| Number Of Medicare Beneficiaries | 419 |
| Total Submitted Charge Amount | 38085 |
| Total Medicare Allowed Amount | 37656.02 |
| Total Medicare Payment Amount | 23945.08 |
| Total Medicare Standardized Payment Amount | 24607.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 478 |
| Number Of Medicare Beneficiaries With Medical Services | 419 |
| Total Medical Submitted Charge Amount | 38085 |
| Total Medical Medicare Allowed Amount | 37656.02 |
| Total Medical Medicare Payment Amount | 23945.08 |
| Total Medical Medicare Standardized Payment Amount | 24607.09 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 231 |
| Number Of Beneficiaries Age 75 to 84 | 114 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 255 |
| Number Of Male Beneficiaries | 164 |
| Number Of Non Hispanic White Beneficiaries | 400 |
| 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 | 392 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9164 |