| National Provider Identifier [NPI]: | 1093713539 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | LARY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 754 SOUTH MAIN |
| Street Address 2 Of The Provider | SUITE 3 |
| City Of The Provider | ST GEORGE |
| Zip Code Of The Provider | 847705504 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 8337 |
| Number Of Medicare Beneficiaries | 936 |
| Total Submitted Charge Amount | 814229.8 |
| Total Medicare Allowed Amount | 554636.2 |
| Total Medicare Payment Amount | 416287.63 |
| Total Medicare Standardized Payment Amount | 409291.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 326 |
| Number Of Medicare Beneficiaries With Drug Services | 78 |
| Total Drug Submitted ChargeAmount | 13134.8 |
| Total Drug Medicare AllowedAmount | 6901.57 |
| Total Drug Medicare PaymentAmount | 5401.6 |
| Total Drug Medicare Standardized Payment Amount | 5401.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 8011 |
| Number Of Medicare Beneficiaries With Medical Services | 936 |
| Total Medical Submitted Charge Amount | 801095 |
| Total Medical Medicare Allowed Amount | 547734.63 |
| Total Medical Medicare Payment Amount | 410886.03 |
| Total Medical Medicare Standardized Payment Amount | 403889.65 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 325 |
| Number Of Beneficiaries Age 75 to 84 | 291 |
| Number Of Beneficiaries Age Greater 84 | 259 |
| Number Of Female Beneficiaries | 536 |
| Number Of Male Beneficiaries | 400 |
| Number Of Non Hispanic White Beneficiaries | 892 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 815 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 121 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4672 |