| National Provider Identifier [NPI]: | 1861470783 |
| Last Name Of The Provider | SMALL |
| First Name Of The Provider | KENT |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 501 NORTH ORANGE STREET |
| Street Address 2 Of The Provider | SUITE 250 |
| City Of The Provider | GLENDALE |
| Zip Code Of The Provider | 912031971 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 33283 |
| Number Of Medicare Beneficiaries | 1145 |
| Total Submitted Charge Amount | 5692183.87 |
| Total Medicare Allowed Amount | 3411694.98 |
| Total Medicare Payment Amount | 2611177.35 |
| Total Medicare Standardized Payment Amount | 2455466.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 4950 |
| Number Of Medicare Beneficiaries With Drug Services | 249 |
| Total Drug Submitted ChargeAmount | 947325.06 |
| Total Drug Medicare AllowedAmount | 823118.1 |
| Total Drug Medicare PaymentAmount | 640931.93 |
| Total Drug Medicare Standardized Payment Amount | 640931.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 28333 |
| Number Of Medicare Beneficiaries With Medical Services | 1145 |
| Total Medical Submitted Charge Amount | 4744858.81 |
| Total Medical Medicare Allowed Amount | 2588576.88 |
| Total Medical Medicare Payment Amount | 1970245.42 |
| Total Medical Medicare Standardized Payment Amount | 1814534.36 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 367 |
| Number Of Beneficiaries Age 75 to 84 | 424 |
| Number Of Beneficiaries Age Greater 84 | 319 |
| Number Of Female Beneficiaries | 711 |
| Number Of Male Beneficiaries | 434 |
| Number Of Non Hispanic White Beneficiaries | 836 |
| Number Of Black or African American Beneficiaries | 47 |
| Number Of AsianPacific Islander Beneficiaries | 89 |
| Number Of Hispanic Beneficiaries | 137 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 738 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 407 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5314 |