| National Provider Identifier [NPI]: | 1164532750 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | ROBERTA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 970 MONUMENT ST |
| Street Address 2 Of The Provider | SUITE 210 |
| City Of The Provider | PACIFIC PALISADES |
| Zip Code Of The Provider | 902723891 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 6533 |
| Number Of Medicare Beneficiaries | 819 |
| Total Submitted Charge Amount | 505575 |
| Total Medicare Allowed Amount | 333502.53 |
| Total Medicare Payment Amount | 253942.38 |
| Total Medicare Standardized Payment Amount | 234545.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 474 |
| Number Of Medicare Beneficiaries With Drug Services | 294 |
| Total Drug Submitted ChargeAmount | 19485 |
| Total Drug Medicare AllowedAmount | 10135.6 |
| Total Drug Medicare PaymentAmount | 9813.63 |
| Total Drug Medicare Standardized Payment Amount | 9813.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 6059 |
| Number Of Medicare Beneficiaries With Medical Services | 817 |
| Total Medical Submitted Charge Amount | 486090 |
| Total Medical Medicare Allowed Amount | 323366.93 |
| Total Medical Medicare Payment Amount | 244128.75 |
| Total Medical Medicare Standardized Payment Amount | 224732.02 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 364 |
| Number Of Beneficiaries Age 75 to 84 | 286 |
| Number Of Beneficiaries Age Greater 84 | 158 |
| Number Of Female Beneficiaries | 625 |
| Number Of Male Beneficiaries | 194 |
| Number Of Non Hispanic White Beneficiaries | 764 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 7 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 10 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 30 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8629 |