| National Provider Identifier [NPI]: | 1477720092 |
| Last Name Of The Provider | SMITAMAN |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 W ARBOR DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921039000 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 153 |
| Number Of Services | 5092 |
| Number Of Medicare Beneficiaries | 3398 |
| Total Submitted Charge Amount | 554466.6 |
| Total Medicare Allowed Amount | 117239.87 |
| Total Medicare Payment Amount | 89353.63 |
| Total Medicare Standardized Payment Amount | 85388.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 153 |
| Number Of Medical Services | 5092 |
| Number Of Medicare Beneficiaries With Medical Services | 3398 |
| Total Medical Submitted Charge Amount | 554466.6 |
| Total Medical Medicare Allowed Amount | 117239.87 |
| Total Medical Medicare Payment Amount | 89353.63 |
| Total Medical Medicare Standardized Payment Amount | 85388.09 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 672 |
| Number Of Beneficiaries Age 65 to 74 | 1116 |
| Number Of Beneficiaries Age 75 to 84 | 919 |
| Number Of Beneficiaries Age Greater 84 | 691 |
| Number Of Female Beneficiaries | 2080 |
| Number Of Male Beneficiaries | 1318 |
| Number Of Non Hispanic White Beneficiaries | 2535 |
| Number Of Black or African American Beneficiaries | 405 |
| Number Of AsianPacific Islander Beneficiaries | 75 |
| Number Of Hispanic Beneficiaries | 301 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2120 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1278 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8921 |