| National Provider Identifier [NPI]: | 1508084807 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | LELAND |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 OAK RIDGE TPKE |
| Street Address 2 Of The Provider | SUITE A300 |
| City Of The Provider | OAK RIDGE |
| Zip Code Of The Provider | 378306957 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 6808 |
| Number Of Medicare Beneficiaries | 1743 |
| Total Submitted Charge Amount | 574355 |
| Total Medicare Allowed Amount | 388870.41 |
| Total Medicare Payment Amount | 273963.55 |
| Total Medicare Standardized Payment Amount | 297588.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 106 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 6100 |
| Total Drug Medicare AllowedAmount | 5025.23 |
| Total Drug Medicare PaymentAmount | 3931.26 |
| Total Drug Medicare Standardized Payment Amount | 3931.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 6702 |
| Number Of Medicare Beneficiaries With Medical Services | 1743 |
| Total Medical Submitted Charge Amount | 568255 |
| Total Medical Medicare Allowed Amount | 383845.18 |
| Total Medical Medicare Payment Amount | 270032.29 |
| Total Medical Medicare Standardized Payment Amount | 293657.17 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 150 |
| Number Of Beneficiaries Age 65 to 74 | 837 |
| Number Of Beneficiaries Age 75 to 84 | 552 |
| Number Of Beneficiaries Age Greater 84 | 204 |
| Number Of Female Beneficiaries | 834 |
| Number Of Male Beneficiaries | 909 |
| Number Of Non Hispanic White Beneficiaries | 1699 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1562 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 181 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0104 |