| National Provider Identifier [NPI]: | 1336173582 |
| Last Name Of The Provider | DAVYDOV |
| First Name Of The Provider | ERIK |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 17909 SOLEDAD CANYON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CANYON COUNTRY |
| Zip Code Of The Provider | 913873210 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 8806 |
| Number Of Medicare Beneficiaries | 2791 |
| Total Submitted Charge Amount | 142680 |
| Total Medicare Allowed Amount | 61720.73 |
| Total Medicare Payment Amount | 51678.02 |
| Total Medicare Standardized Payment Amount | 49867.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 1165 |
| Total Drug Medicare AllowedAmount | 657 |
| Total Drug Medicare PaymentAmount | 640.84 |
| Total Drug Medicare Standardized Payment Amount | 640.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 8782 |
| Number Of Medicare Beneficiaries With Medical Services | 2791 |
| Total Medical Submitted Charge Amount | 141515 |
| Total Medical Medicare Allowed Amount | 61063.73 |
| Total Medical Medicare Payment Amount | 51037.18 |
| Total Medical Medicare Standardized Payment Amount | 49226.73 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 403 |
| Number Of Beneficiaries Age 65 to 74 | 1274 |
| Number Of Beneficiaries Age 75 to 84 | 793 |
| Number Of Beneficiaries Age Greater 84 | 321 |
| Number Of Female Beneficiaries | 1659 |
| Number Of Male Beneficiaries | 1132 |
| Number Of Non Hispanic White Beneficiaries | 1250 |
| Number Of Black or African American Beneficiaries | 108 |
| Number Of AsianPacific Islander Beneficiaries | 235 |
| Number Of Hispanic Beneficiaries | 1125 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1716 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1075 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1976 |