| National Provider Identifier [NPI]: | 1477526259 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | RAYMOND |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1101 BROADWAY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | QUINCY |
| Zip Code Of The Provider | 623012809 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 166 |
| Number Of Services | 108778 |
| Number Of Medicare Beneficiaries | 901 |
| Total Submitted Charge Amount | 5341842.78 |
| Total Medicare Allowed Amount | 2416981.95 |
| Total Medicare Payment Amount | 1867515.57 |
| Total Medicare Standardized Payment Amount | 1877869.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 87 |
| Number Of Drug Services | 103708 |
| Number Of Medicare Beneficiaries With Drug Services | 312 |
| Total Drug Submitted ChargeAmount | 4316319.14 |
| Total Drug Medicare AllowedAmount | 2060922.85 |
| Total Drug Medicare PaymentAmount | 1598456.45 |
| Total Drug Medicare Standardized Payment Amount | 1598456.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 5070 |
| Number Of Medicare Beneficiaries With Medical Services | 897 |
| Total Medical Submitted Charge Amount | 1025523.64 |
| Total Medical Medicare Allowed Amount | 356059.1 |
| Total Medical Medicare Payment Amount | 269059.12 |
| Total Medical Medicare Standardized Payment Amount | 279413.02 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 350 |
| Number Of Beneficiaries Age 75 to 84 | 324 |
| Number Of Beneficiaries Age Greater 84 | 131 |
| Number Of Female Beneficiaries | 552 |
| Number Of Male Beneficiaries | 349 |
| Number Of Non Hispanic White Beneficiaries | 877 |
| 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 | 738 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 163 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 54 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.8896 |