| National Provider Identifier [NPI]: | 1154546166 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | ANTHONY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 220 N PHOENIX AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | RUSSELLVILLE |
| Zip Code Of The Provider | 728012826 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 1955 |
| Number Of Medicare Beneficiaries | 583 |
| Total Submitted Charge Amount | 441450.94 |
| Total Medicare Allowed Amount | 183680.01 |
| Total Medicare Payment Amount | 132343.54 |
| Total Medicare Standardized Payment Amount | 147376.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 480 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 5737.88 |
| Total Drug Medicare AllowedAmount | 2312.84 |
| Total Drug Medicare PaymentAmount | 1796.14 |
| Total Drug Medicare Standardized Payment Amount | 1796.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 1475 |
| Number Of Medicare Beneficiaries With Medical Services | 583 |
| Total Medical Submitted Charge Amount | 435713.06 |
| Total Medical Medicare Allowed Amount | 181367.17 |
| Total Medical Medicare Payment Amount | 130547.4 |
| Total Medical Medicare Standardized Payment Amount | 145580.37 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 168 |
| Number Of Beneficiaries Age 65 to 74 | 206 |
| Number Of Beneficiaries Age 75 to 84 | 150 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 339 |
| Number Of Male Beneficiaries | 244 |
| Number Of Non Hispanic White Beneficiaries | 548 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 385 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 198 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.2952 |