| National Provider Identifier [NPI]: | 1528047149 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | MITCHELL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 S ENOTA DR NE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 305013466 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 9298 |
| Number Of Medicare Beneficiaries | 3230 |
| Total Submitted Charge Amount | 1816309.91 |
| Total Medicare Allowed Amount | 627108.57 |
| Total Medicare Payment Amount | 467084.93 |
| Total Medicare Standardized Payment Amount | 489486.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 470 |
| Number Of Medicare Beneficiaries With Drug Services | 121 |
| Total Drug Submitted ChargeAmount | 61722.91 |
| Total Drug Medicare AllowedAmount | 24935.47 |
| Total Drug Medicare PaymentAmount | 19410.08 |
| Total Drug Medicare Standardized Payment Amount | 19410.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 8828 |
| Number Of Medicare Beneficiaries With Medical Services | 3230 |
| Total Medical Submitted Charge Amount | 1754587 |
| Total Medical Medicare Allowed Amount | 602173.1 |
| Total Medical Medicare Payment Amount | 447674.85 |
| Total Medical Medicare Standardized Payment Amount | 470076.68 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 368 |
| Number Of Beneficiaries Age 65 to 74 | 1297 |
| Number Of Beneficiaries Age 75 to 84 | 1063 |
| Number Of Beneficiaries Age Greater 84 | 502 |
| Number Of Female Beneficiaries | 1660 |
| Number Of Male Beneficiaries | 1570 |
| Number Of Non Hispanic White Beneficiaries | 3052 |
| Number Of Black or African American Beneficiaries | 92 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2557 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 673 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6646 |