| National Provider Identifier [NPI]: | 1275725426 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | RNFA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3110 N LLOYD BUSH DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 857459071 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 435 |
| Number Of Medicare Beneficiaries | 385 |
| Total Submitted Charge Amount | 147328.77 |
| Total Medicare Allowed Amount | 34672.65 |
| Total Medicare Payment Amount | 26019.02 |
| Total Medicare Standardized Payment Amount | 31221.76 |
| 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 | 44 |
| Number Of Medical Services | 435 |
| Number Of Medicare Beneficiaries With Medical Services | 385 |
| Total Medical Submitted Charge Amount | 147328.77 |
| Total Medical Medicare Allowed Amount | 34672.65 |
| Total Medical Medicare Payment Amount | 26019.02 |
| Total Medical Medicare Standardized Payment Amount | 31221.76 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 199 |
| Number Of Beneficiaries Age 75 to 84 | 111 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 217 |
| Number Of Male Beneficiaries | 168 |
| Number Of Non Hispanic White Beneficiaries | 355 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 363 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.8976 |