Medicare Facts for Pennie L. Smith, PA


National Provider Identifier [NPI]: 1194732271
Last Name Of The Provider SMITH
First Name Of The Provider PENNIE
Middle Initial Of The Provider L
Credentials Of The Provider PA
Gender Of The Provider F
Entity Type Of The Provider I
Street Address 1 Of The Provider 1201 PINE STREET
Street Address 2 Of The Provider
City Of The Provider ELDORADO
Zip Code Of The Provider 62930
State Code Of The Provider IL
Country Code Of The Provider US
Provider Type Of The Provider Physician Assistant
Medicare Participation Indicator Y
Number Of HCPCS 7
Number Of Services 247
Number Of Medicare Beneficiaries 213
Total Submitted Charge Amount 69481
Total Medicare Allowed Amount 21100.06
Total Medicare Payment Amount 16214.25
Total Medicare Standardized Payment Amount 19481.01
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 7
Number Of Medical Services 247
Number Of Medicare Beneficiaries With Medical Services 213
Total Medical Submitted Charge Amount 69481
Total Medical Medicare Allowed Amount 21100.06
Total Medical Medicare Payment Amount 16214.25
Total Medical Medicare Standardized Payment Amount 19481.01
Average Age Of Beneficiaries 69
Number Of Beneficiaries Age Less65 71
Number Of Beneficiaries Age 65 to 74 60
Number Of Beneficiaries Age 75 to 84 56
Number Of Beneficiaries Age Greater 84 26
Number Of Female Beneficiaries 120
Number Of Male Beneficiaries 93
Number Of Non Hispanic White Beneficiaries
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 105
Number Of Beneficiaries With Medicare Medicaid Entitlement 108
Percent Of With Atrial Fibrillation 17
Percent Of With Alzheimers Disease or Dementia 22
Percent Of With Asthma 6
Percent Of With Cancer 7
Percent Of With Heart Failure 29
Percent Of With Chronic Kidney Disease 29
Percent Of With Chronic Obstructive Pulmonary Disease 38
Percent Of With Depression 33
Percent Of With Diabetes 38
Percent Of With Hyperlipidemia 44
Percent Of With Hypertension 71
Percent Of With Ischemic Heart Disease 41
Percent Of With Osteoporosis
Percent Of With Rheumatoid Arthritis Osteoarthritis 37
Percent Of With Schizophrenia Other PsychoticDisorders 14
Percent Of With Stroke 9
Average HCC Risk Score Of Beneficiaries 1.4464

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