| National Provider Identifier [NPI]: | 1558357152 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | WADE |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 812 N NOLAN RIVER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLEBURNE |
| Zip Code Of The Provider | 760337012 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 17727 |
| Number Of Medicare Beneficiaries | 2378 |
| Total Submitted Charge Amount | 599093.03 |
| Total Medicare Allowed Amount | 524642.97 |
| Total Medicare Payment Amount | 367864.32 |
| Total Medicare Standardized Payment Amount | 380253.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 285 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 777 |
| Total Drug Medicare AllowedAmount | 738.35 |
| Total Drug Medicare PaymentAmount | 522.4 |
| Total Drug Medicare Standardized Payment Amount | 522.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 17442 |
| Number Of Medicare Beneficiaries With Medical Services | 2378 |
| Total Medical Submitted Charge Amount | 598316.03 |
| Total Medical Medicare Allowed Amount | 523904.62 |
| Total Medical Medicare Payment Amount | 367341.92 |
| Total Medical Medicare Standardized Payment Amount | 379730.72 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 938 |
| Number Of Beneficiaries Age 75 to 84 | 976 |
| Number Of Beneficiaries Age Greater 84 | 380 |
| Number Of Female Beneficiaries | 1131 |
| Number Of Male Beneficiaries | 1247 |
| Number Of Non Hispanic White Beneficiaries | 2345 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2252 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 126 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9869 |