| National Provider Identifier [NPI]: | 1649290685 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | LAUREN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 550 E WASHINGTON ST |
| Street Address 2 Of The Provider | STE 205 |
| City Of The Provider | IONIA |
| Zip Code Of The Provider | 488462202 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 55 |
| Number Of Medicare Beneficiaries | 34 |
| Total Submitted Charge Amount | 4520 |
| Total Medicare Allowed Amount | 3688.18 |
| Total Medicare Payment Amount | 2275.32 |
| Total Medicare Standardized Payment Amount | 3128.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 21 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 1638 |
| Total Drug Medicare AllowedAmount | 1607.35 |
| Total Drug Medicare PaymentAmount | 1575.14 |
| Total Drug Medicare Standardized Payment Amount | 1575.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 6 |
| Number Of Medical Services | 34 |
| Number Of Medicare Beneficiaries With Medical Services | 24 |
| Total Medical Submitted Charge Amount | 2882 |
| Total Medical Medicare Allowed Amount | 2080.83 |
| Total Medical Medicare Payment Amount | 700.18 |
| Total Medical Medicare Standardized Payment Amount | 1553.39 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 17 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 17 |
| Number Of Male Beneficiaries | 17 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 0 |
| Percent Of With Cancer | 0 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | |
| Percent Of With Hypertension | 41 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | 0 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | 0 |
| Average HCC Risk Score Of Beneficiaries | 0.831 |