| National Provider Identifier [NPI]: | 1144205576 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10010 KENNERLY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631282106 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 148 |
| Number Of Services | 3285 |
| Number Of Medicare Beneficiaries | 2281 |
| Total Submitted Charge Amount | 267455 |
| Total Medicare Allowed Amount | 99465.15 |
| Total Medicare Payment Amount | 71312.89 |
| Total Medicare Standardized Payment Amount | 73297.46 |
| 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 | 148 |
| Number Of Medical Services | 3285 |
| Number Of Medicare Beneficiaries With Medical Services | 2281 |
| Total Medical Submitted Charge Amount | 267455 |
| Total Medical Medicare Allowed Amount | 99465.15 |
| Total Medical Medicare Payment Amount | 71312.89 |
| Total Medical Medicare Standardized Payment Amount | 73297.46 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 447 |
| Number Of Beneficiaries Age 65 to 74 | 722 |
| Number Of Beneficiaries Age 75 to 84 | 670 |
| Number Of Beneficiaries Age Greater 84 | 442 |
| Number Of Female Beneficiaries | 1250 |
| Number Of Male Beneficiaries | 1031 |
| Number Of Non Hispanic White Beneficiaries | 2143 |
| Number Of Black or African American Beneficiaries | 71 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1824 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 457 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.1144 |