| National Provider Identifier [NPI]: | 1619079712 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7253 AMBASSADOR RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212442710 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 158 |
| Number Of Services | 38550 |
| Number Of Medicare Beneficiaries | 5177 |
| Total Submitted Charge Amount | 1678270.12 |
| Total Medicare Allowed Amount | 487413.35 |
| Total Medicare Payment Amount | 369898.65 |
| Total Medicare Standardized Payment Amount | 354425.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 31004 |
| Number Of Medicare Beneficiaries With Drug Services | 319 |
| Total Drug Submitted ChargeAmount | 7849.15 |
| Total Drug Medicare AllowedAmount | 6294.82 |
| Total Drug Medicare PaymentAmount | 4562.41 |
| Total Drug Medicare Standardized Payment Amount | 4562.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 156 |
| Number Of Medical Services | 7546 |
| Number Of Medicare Beneficiaries With Medical Services | 5177 |
| Total Medical Submitted Charge Amount | 1670420.97 |
| Total Medical Medicare Allowed Amount | 481118.53 |
| Total Medical Medicare Payment Amount | 365336.24 |
| Total Medical Medicare Standardized Payment Amount | 349862.8 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 884 |
| Number Of Beneficiaries Age 65 to 74 | 1952 |
| Number Of Beneficiaries Age 75 to 84 | 1492 |
| Number Of Beneficiaries Age Greater 84 | 849 |
| Number Of Female Beneficiaries | 3239 |
| Number Of Male Beneficiaries | 1938 |
| Number Of Non Hispanic White Beneficiaries | 4387 |
| Number Of Black or African American Beneficiaries | 619 |
| Number Of AsianPacific Islander Beneficiaries | 57 |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 4257 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 920 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.639 |