| National Provider Identifier [NPI]: | 1710980206 |
| Last Name Of The Provider | SMOCK |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11274 S FORTUNA RD STE I4 |
| Street Address 2 Of The Provider | 558 ABBOTT ST STE A |
| City Of The Provider | YUMA |
| Zip Code Of The Provider | 853677849 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 2377 |
| Number Of Medicare Beneficiaries | 202 |
| Total Submitted Charge Amount | 121520.36 |
| Total Medicare Allowed Amount | 79060 |
| Total Medicare Payment Amount | 53929.22 |
| Total Medicare Standardized Payment Amount | 57985.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 1109 |
| Number Of Medicare Beneficiaries With Drug Services | 101 |
| Total Drug Submitted ChargeAmount | 5530.36 |
| Total Drug Medicare AllowedAmount | 646.65 |
| Total Drug Medicare PaymentAmount | 499.27 |
| Total Drug Medicare Standardized Payment Amount | 499.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 1268 |
| Number Of Medicare Beneficiaries With Medical Services | 202 |
| Total Medical Submitted Charge Amount | 115990 |
| Total Medical Medicare Allowed Amount | 78413.35 |
| Total Medical Medicare Payment Amount | 53429.95 |
| Total Medical Medicare Standardized Payment Amount | 57485.8 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 83 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 104 |
| Number Of Male Beneficiaries | 98 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 152 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 50 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9229 |