National Provider Identifier [NPI]: |
1366420556 |
Last Name Of The Provider |
DAVIS |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3061 S MARYLAND PKWY |
Street Address 2 Of The Provider |
SUITE 102 |
City Of The Provider |
LAS VEGAS |
Zip Code Of The Provider |
891092298 |
State Code Of The Provider |
NV |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
238 |
Number Of Services |
4173 |
Number Of Medicare Beneficiaries |
2532 |
Total Submitted Charge Amount |
561296 |
Total Medicare Allowed Amount |
171810.5 |
Total Medicare Payment Amount |
133112.6 |
Total Medicare Standardized Payment Amount |
130603.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
238 |
Number Of Medical Services |
4173 |
Number Of Medicare Beneficiaries With Medical Services |
2532 |
Total Medical Submitted Charge Amount |
561296 |
Total Medical Medicare Allowed Amount |
171810.5 |
Total Medical Medicare Payment Amount |
133112.6 |
Total Medical Medicare Standardized Payment Amount |
130603.9 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
510 |
Number Of Beneficiaries Age 65 to 74 |
890 |
Number Of Beneficiaries Age 75 to 84 |
783 |
Number Of Beneficiaries Age Greater 84 |
349 |
Number Of Female Beneficiaries |
1317 |
Number Of Male Beneficiaries |
1215 |
Number Of Non Hispanic White Beneficiaries |
1755 |
Number Of Black or African American Beneficiaries |
352 |
Number Of AsianPacific Islander Beneficiaries |
112 |
Number Of Hispanic Beneficiaries |
262 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1846 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
686 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
42 |
Percent Of With Chronic Kidney Disease |
57 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.3701 |