| National Provider Identifier [NPI]: | 1780661066 |
| Last Name Of The Provider | DAVID |
| First Name Of The Provider | ALICE |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 820 ST.SEBASTIAN WAY |
| Street Address 2 Of The Provider | SUITE 3A |
| City Of The Provider | AUGUSTA |
| Zip Code Of The Provider | 30901 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 140 |
| Number Of Services | 103380 |
| Number Of Medicare Beneficiaries | 659 |
| Total Submitted Charge Amount | 3268775 |
| Total Medicare Allowed Amount | 1513660.05 |
| Total Medicare Payment Amount | 1164456.83 |
| Total Medicare Standardized Payment Amount | 1174894.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 72 |
| Number Of Drug Services | 95183 |
| Number Of Medicare Beneficiaries With Drug Services | 261 |
| Total Drug Submitted ChargeAmount | 2575432 |
| Total Drug Medicare AllowedAmount | 1265313.16 |
| Total Drug Medicare PaymentAmount | 969842.03 |
| Total Drug Medicare Standardized Payment Amount | 969842.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 8197 |
| Number Of Medicare Beneficiaries With Medical Services | 659 |
| Total Medical Submitted Charge Amount | 693343 |
| Total Medical Medicare Allowed Amount | 248346.89 |
| Total Medical Medicare Payment Amount | 194614.8 |
| Total Medical Medicare Standardized Payment Amount | 205051.98 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 299 |
| Number Of Beneficiaries Age 75 to 84 | 224 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 476 |
| Number Of Male Beneficiaries | 183 |
| Number Of Non Hispanic White Beneficiaries | 464 |
| Number Of Black or African American Beneficiaries | 171 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 560 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 99 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 48 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.6169 |