| National Provider Identifier [NPI]: | 1457354631 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | HUBERT |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 658 NORTHSIDE DR E |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | STATESBORO |
| Zip Code Of The Provider | 304584828 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 105 |
| Number Of Services | 9134 |
| Number Of Medicare Beneficiaries | 794 |
| Total Submitted Charge Amount | 643662.96 |
| Total Medicare Allowed Amount | 277258.32 |
| Total Medicare Payment Amount | 214163.1 |
| Total Medicare Standardized Payment Amount | 227629.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 746 |
| Number Of Medicare Beneficiaries With Drug Services | 308 |
| Total Drug Submitted ChargeAmount | 24122 |
| Total Drug Medicare AllowedAmount | 9077.02 |
| Total Drug Medicare PaymentAmount | 8728.57 |
| Total Drug Medicare Standardized Payment Amount | 8728.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 90 |
| Number Of Medical Services | 8388 |
| Number Of Medicare Beneficiaries With Medical Services | 794 |
| Total Medical Submitted Charge Amount | 619540.96 |
| Total Medical Medicare Allowed Amount | 268181.3 |
| Total Medical Medicare Payment Amount | 205434.53 |
| Total Medical Medicare Standardized Payment Amount | 218900.57 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 374 |
| Number Of Beneficiaries Age 75 to 84 | 266 |
| Number Of Beneficiaries Age Greater 84 | 96 |
| Number Of Female Beneficiaries | 435 |
| Number Of Male Beneficiaries | 359 |
| Number Of Non Hispanic White Beneficiaries | 693 |
| 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 | 688 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 106 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0309 |