| National Provider Identifier [NPI]: | 1912969510 |
| Last Name Of The Provider | SMULLEN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 524 S PARK ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | KALAMAZOO |
| Zip Code Of The Provider | 490075118 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 103 |
| Number Of Services | 4555 |
| Number Of Medicare Beneficiaries | 1993 |
| Total Submitted Charge Amount | 1012254 |
| Total Medicare Allowed Amount | 169980.89 |
| Total Medicare Payment Amount | 129630.78 |
| Total Medicare Standardized Payment Amount | 137701 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1669 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 6739 |
| Total Drug Medicare AllowedAmount | 1628.39 |
| Total Drug Medicare PaymentAmount | 1276.72 |
| Total Drug Medicare Standardized Payment Amount | 1276.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 101 |
| Number Of Medical Services | 2886 |
| Number Of Medicare Beneficiaries With Medical Services | 1993 |
| Total Medical Submitted Charge Amount | 1005515 |
| Total Medical Medicare Allowed Amount | 168352.5 |
| Total Medical Medicare Payment Amount | 128354.06 |
| Total Medical Medicare Standardized Payment Amount | 136424.28 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 506 |
| Number Of Beneficiaries Age 65 to 74 | 590 |
| Number Of Beneficiaries Age 75 to 84 | 530 |
| Number Of Beneficiaries Age Greater 84 | 367 |
| Number Of Female Beneficiaries | 1124 |
| Number Of Male Beneficiaries | 869 |
| Number Of Non Hispanic White Beneficiaries | 1741 |
| Number Of Black or African American Beneficiaries | 182 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1368 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 625 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 1.7033 |