| National Provider Identifier [NPI]: | 1710046628 |
| Last Name Of The Provider | SIRE |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 W BASTANCHURY RD |
| Street Address 2 Of The Provider | SUITE 210 |
| City Of The Provider | FULLERTON |
| Zip Code Of The Provider | 928353419 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 4553 |
| Number Of Medicare Beneficiaries | 501 |
| Total Submitted Charge Amount | 724610 |
| Total Medicare Allowed Amount | 519858.31 |
| Total Medicare Payment Amount | 394218.02 |
| Total Medicare Standardized Payment Amount | 326543.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 122 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 1178 |
| Total Drug Medicare AllowedAmount | 1092.48 |
| Total Drug Medicare PaymentAmount | 568.57 |
| Total Drug Medicare Standardized Payment Amount | 568.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 4431 |
| Number Of Medicare Beneficiaries With Medical Services | 501 |
| Total Medical Submitted Charge Amount | 723432 |
| Total Medical Medicare Allowed Amount | 518765.83 |
| Total Medical Medicare Payment Amount | 393649.45 |
| Total Medical Medicare Standardized Payment Amount | 325975.36 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 219 |
| Number Of Beneficiaries Age 75 to 84 | 192 |
| Number Of Beneficiaries Age Greater 84 | 76 |
| Number Of Female Beneficiaries | 254 |
| Number Of Male Beneficiaries | 247 |
| Number Of Non Hispanic White Beneficiaries | 449 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 484 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0051 |