| National Provider Identifier [NPI]: | 1992761894 |
| Last Name Of The Provider | SMALL |
| First Name Of The Provider | SAMUEL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 168 N BRENT ST |
| Street Address 2 Of The Provider | 505 |
| City Of The Provider | VENTURA |
| Zip Code Of The Provider | 930032817 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 866 |
| Number Of Medicare Beneficiaries | 257 |
| Total Submitted Charge Amount | 364263 |
| Total Medicare Allowed Amount | 133755.48 |
| Total Medicare Payment Amount | 102201.53 |
| Total Medicare Standardized Payment Amount | 96166.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 39 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 280 |
| Total Drug Medicare AllowedAmount | 73.48 |
| Total Drug Medicare PaymentAmount | 56.46 |
| Total Drug Medicare Standardized Payment Amount | 56.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 827 |
| Number Of Medicare Beneficiaries With Medical Services | 257 |
| Total Medical Submitted Charge Amount | 363983 |
| Total Medical Medicare Allowed Amount | 133682 |
| Total Medical Medicare Payment Amount | 102145.07 |
| Total Medical Medicare Standardized Payment Amount | 96110.03 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 123 |
| Number Of Beneficiaries Age 75 to 84 | 91 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 159 |
| Number Of Male Beneficiaries | 98 |
| Number Of Non Hispanic White Beneficiaries | 228 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 63 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1093 |