| National Provider Identifier [NPI]: | 1902855265 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 409 GLENWOOD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | GLEN ROSE |
| Zip Code Of The Provider | 760434933 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 3225 |
| Number Of Medicare Beneficiaries | 516 |
| Total Submitted Charge Amount | 379861 |
| Total Medicare Allowed Amount | 169030.47 |
| Total Medicare Payment Amount | 121210.49 |
| Total Medicare Standardized Payment Amount | 128971.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 692 |
| Number Of Medicare Beneficiaries With Drug Services | 264 |
| Total Drug Submitted ChargeAmount | 20028 |
| Total Drug Medicare AllowedAmount | 9490.37 |
| Total Drug Medicare PaymentAmount | 8683.39 |
| Total Drug Medicare Standardized Payment Amount | 8683.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 2533 |
| Number Of Medicare Beneficiaries With Medical Services | 516 |
| Total Medical Submitted Charge Amount | 359833 |
| Total Medical Medicare Allowed Amount | 159540.1 |
| Total Medical Medicare Payment Amount | 112527.1 |
| Total Medical Medicare Standardized Payment Amount | 120287.85 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 248 |
| Number Of Beneficiaries Age 75 to 84 | 172 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 266 |
| Number Of Male Beneficiaries | 250 |
| Number Of Non Hispanic White Beneficiaries | 505 |
| Number Of Black or African American Beneficiaries | 0 |
| 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 | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 470 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0104 |