| National Provider Identifier [NPI]: | 1255490330 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 550 WASHINGTON ST |
| Street Address 2 Of The Provider | #723 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921032232 |
| 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 | 43 |
| Number Of Services | 6724 |
| Number Of Medicare Beneficiaries | 1133 |
| Total Submitted Charge Amount | 2274830 |
| Total Medicare Allowed Amount | 1357362.27 |
| Total Medicare Payment Amount | 1040957.72 |
| Total Medicare Standardized Payment Amount | 1026104.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1129 |
| Number Of Medicare Beneficiaries With Drug Services | 220 |
| Total Drug Submitted ChargeAmount | 924215 |
| Total Drug Medicare AllowedAmount | 781976.75 |
| Total Drug Medicare PaymentAmount | 611380.09 |
| Total Drug Medicare Standardized Payment Amount | 611380.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 5595 |
| Number Of Medicare Beneficiaries With Medical Services | 1133 |
| Total Medical Submitted Charge Amount | 1350615 |
| Total Medical Medicare Allowed Amount | 575385.52 |
| Total Medical Medicare Payment Amount | 429577.63 |
| Total Medical Medicare Standardized Payment Amount | 414724.35 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | 417 |
| Number Of Beneficiaries Age 75 to 84 | 354 |
| Number Of Beneficiaries Age Greater 84 | 284 |
| Number Of Female Beneficiaries | 626 |
| Number Of Male Beneficiaries | 507 |
| Number Of Non Hispanic White Beneficiaries | 878 |
| Number Of Black or African American Beneficiaries | 34 |
| Number Of AsianPacific Islander Beneficiaries | 54 |
| Number Of Hispanic Beneficiaries | 146 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 941 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 192 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.5386 |