| National Provider Identifier [NPI]: | 1265604243 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | LIZA |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 759 CHESTNUT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 011991619 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 818 |
| Number Of Medicare Beneficiaries | 724 |
| Total Submitted Charge Amount | 254077 |
| Total Medicare Allowed Amount | 118150.29 |
| Total Medicare Payment Amount | 90167.81 |
| Total Medicare Standardized Payment Amount | 90009.22 |
| 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 | 33 |
| Number Of Medical Services | 818 |
| Number Of Medicare Beneficiaries With Medical Services | 724 |
| Total Medical Submitted Charge Amount | 254077 |
| Total Medical Medicare Allowed Amount | 118150.29 |
| Total Medical Medicare Payment Amount | 90167.81 |
| Total Medical Medicare Standardized Payment Amount | 90009.22 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 238 |
| Number Of Beneficiaries Age 65 to 74 | 193 |
| Number Of Beneficiaries Age 75 to 84 | 150 |
| Number Of Beneficiaries Age Greater 84 | 143 |
| Number Of Female Beneficiaries | 399 |
| Number Of Male Beneficiaries | 325 |
| Number Of Non Hispanic White Beneficiaries | 503 |
| Number Of Black or African American Beneficiaries | 75 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 127 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 361 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 363 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.2465 |