| National Provider Identifier [NPI]: | 1144257536 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | ROGER |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 909 HYDE ST. |
| Street Address 2 Of The Provider | SUITE #531 |
| City Of The Provider | SAN FRANCISCO |
| Zip Code Of The Provider | 941060001 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Otolaryngology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 873 |
| Number Of Medicare Beneficiaries | 275 |
| Total Submitted Charge Amount | 123327 |
| Total Medicare Allowed Amount | 87364.52 |
| Total Medicare Payment Amount | 63834.78 |
| Total Medicare Standardized Payment Amount | 53052.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 108 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 1512 |
| Total Drug Medicare AllowedAmount | 616.56 |
| Total Drug Medicare PaymentAmount | 465.13 |
| Total Drug Medicare Standardized Payment Amount | 465.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 765 |
| Number Of Medicare Beneficiaries With Medical Services | 275 |
| Total Medical Submitted Charge Amount | 121815 |
| Total Medical Medicare Allowed Amount | 86747.96 |
| Total Medical Medicare Payment Amount | 63369.65 |
| Total Medical Medicare Standardized Payment Amount | 52587.7 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 87 |
| Number Of Beneficiaries Age 75 to 84 | 98 |
| Number Of Beneficiaries Age Greater 84 | 78 |
| Number Of Female Beneficiaries | 122 |
| Number Of Male Beneficiaries | 153 |
| Number Of Non Hispanic White Beneficiaries | 214 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 236 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0686 |