| National Provider Identifier [NPI]: | 1417953407 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | DANIEL |
| 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 | 551 N HILLSIDE ST |
| Street Address 2 Of The Provider | STE 320 |
| City Of The Provider | WICHITA |
| Zip Code Of The Provider | 672144926 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 195 |
| Number Of Services | 6022 |
| Number Of Medicare Beneficiaries | 2375 |
| Total Submitted Charge Amount | 453001.6 |
| Total Medicare Allowed Amount | 121779.27 |
| Total Medicare Payment Amount | 92306.7 |
| Total Medicare Standardized Payment Amount | 98658.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2482 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 766.6 |
| Total Drug Medicare AllowedAmount | 711.09 |
| Total Drug Medicare PaymentAmount | 557.51 |
| Total Drug Medicare Standardized Payment Amount | 557.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 192 |
| Number Of Medical Services | 3540 |
| Number Of Medicare Beneficiaries With Medical Services | 2375 |
| Total Medical Submitted Charge Amount | 452235 |
| Total Medical Medicare Allowed Amount | 121068.18 |
| Total Medical Medicare Payment Amount | 91749.19 |
| Total Medical Medicare Standardized Payment Amount | 98101.2 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 489 |
| Number Of Beneficiaries Age 65 to 74 | 714 |
| Number Of Beneficiaries Age 75 to 84 | 703 |
| Number Of Beneficiaries Age Greater 84 | 469 |
| Number Of Female Beneficiaries | 1339 |
| Number Of Male Beneficiaries | 1036 |
| Number Of Non Hispanic White Beneficiaries | 2065 |
| Number Of Black or African American Beneficiaries | 177 |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 72 |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1798 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 577 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6765 |