| National Provider Identifier [NPI]: | 1811930357 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3703 CAMINO DEL RIO S |
| Street Address 2 Of The Provider | 210 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921084031 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 130 |
| Number Of Services | 6920 |
| Number Of Medicare Beneficiaries | 335 |
| Total Submitted Charge Amount | 5034931.81 |
| Total Medicare Allowed Amount | 4238403.69 |
| Total Medicare Payment Amount | 3311124.47 |
| Total Medicare Standardized Payment Amount | 3298701.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 1158 |
| Number Of Medicare Beneficiaries With Drug Services | 180 |
| Total Drug Submitted ChargeAmount | 55535 |
| Total Drug Medicare AllowedAmount | 12713.27 |
| Total Drug Medicare PaymentAmount | 9964.93 |
| Total Drug Medicare Standardized Payment Amount | 9964.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 118 |
| Number Of Medical Services | 5762 |
| Number Of Medicare Beneficiaries With Medical Services | 334 |
| Total Medical Submitted Charge Amount | 4979396.81 |
| Total Medical Medicare Allowed Amount | 4225690.42 |
| Total Medical Medicare Payment Amount | 3301159.54 |
| Total Medical Medicare Standardized Payment Amount | 3288736.98 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 196 |
| Number Of Beneficiaries Age 65 to 74 | 102 |
| Number Of Beneficiaries Age 75 to 84 | 25 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 208 |
| Number Of Male Beneficiaries | 127 |
| Number Of Non Hispanic White Beneficiaries | 256 |
| Number Of Black or African American Beneficiaries | 41 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 126 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 209 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 61 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 20 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.1645 |