| National Provider Identifier [NPI]: | 1699774539 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | DEMETRIA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6100 PRIMACY PKWY |
| Street Address 2 Of The Provider | SUITE 112 |
| City Of The Provider | MEMPHIS |
| Zip Code Of The Provider | 381190705 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 1133 |
| Number Of Medicare Beneficiaries | 320 |
| Total Submitted Charge Amount | 180384 |
| Total Medicare Allowed Amount | 72547.66 |
| Total Medicare Payment Amount | 54117.98 |
| Total Medicare Standardized Payment Amount | 71009.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 68 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 5000 |
| Total Drug Medicare AllowedAmount | 3294.12 |
| Total Drug Medicare PaymentAmount | 2582.78 |
| Total Drug Medicare Standardized Payment Amount | 2582.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 1065 |
| Number Of Medicare Beneficiaries With Medical Services | 320 |
| Total Medical Submitted Charge Amount | 175384 |
| Total Medical Medicare Allowed Amount | 69253.54 |
| Total Medical Medicare Payment Amount | 51535.2 |
| Total Medical Medicare Standardized Payment Amount | 68426.95 |
| Average Age Of Beneficiaries | 55 |
| Number Of Beneficiaries Age Less65 | 245 |
| Number Of Beneficiaries Age 65 to 74 | 55 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 222 |
| Number Of Male Beneficiaries | 98 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 191 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 85 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 235 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.6806 |