| National Provider Identifier [NPI]: | 1952356255 |
| Last Name Of The Provider | SMALBERG |
| First Name Of The Provider | IRA |
| 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 | 2202 WILSHIRE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANTA MONICA |
| Zip Code Of The Provider | 904035706 |
| 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 | 140 |
| Number Of Services | 29854 |
| Number Of Medicare Beneficiaries | 3782 |
| Total Submitted Charge Amount | 1506670 |
| Total Medicare Allowed Amount | 372829.03 |
| Total Medicare Payment Amount | 283467.38 |
| Total Medicare Standardized Payment Amount | 260149.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 23024 |
| Number Of Medicare Beneficiaries With Drug Services | 251 |
| Total Drug Submitted ChargeAmount | 24466 |
| Total Drug Medicare AllowedAmount | 4754.07 |
| Total Drug Medicare PaymentAmount | 3715.22 |
| Total Drug Medicare Standardized Payment Amount | 3715.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 137 |
| Number Of Medical Services | 6830 |
| Number Of Medicare Beneficiaries With Medical Services | 3782 |
| Total Medical Submitted Charge Amount | 1482204 |
| Total Medical Medicare Allowed Amount | 368074.96 |
| Total Medical Medicare Payment Amount | 279752.16 |
| Total Medical Medicare Standardized Payment Amount | 256434.05 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 206 |
| Number Of Beneficiaries Age 65 to 74 | 1324 |
| Number Of Beneficiaries Age 75 to 84 | 1262 |
| Number Of Beneficiaries Age Greater 84 | 990 |
| Number Of Female Beneficiaries | 2205 |
| Number Of Male Beneficiaries | 1577 |
| Number Of Non Hispanic White Beneficiaries | 3095 |
| Number Of Black or African American Beneficiaries | 146 |
| Number Of AsianPacific Islander Beneficiaries | 188 |
| Number Of Hispanic Beneficiaries | 254 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2994 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 788 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6623 |