| National Provider Identifier [NPI]: | 1730214578 |
| Last Name Of The Provider | DAVIES |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 430 N MONTE VISTA ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ADA |
| Zip Code Of The Provider | 748204610 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 184 |
| Number Of Services | 8395 |
| Number Of Medicare Beneficiaries | 3408 |
| Total Submitted Charge Amount | 740522.5 |
| Total Medicare Allowed Amount | 239821.92 |
| Total Medicare Payment Amount | 175407.11 |
| Total Medicare Standardized Payment Amount | 187112.51 |
| 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 | 184 |
| Number Of Medical Services | 8395 |
| Number Of Medicare Beneficiaries With Medical Services | 3408 |
| Total Medical Submitted Charge Amount | 740522.5 |
| Total Medical Medicare Allowed Amount | 239821.92 |
| Total Medical Medicare Payment Amount | 175407.11 |
| Total Medical Medicare Standardized Payment Amount | 187112.51 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 780 |
| Number Of Beneficiaries Age 65 to 74 | 1273 |
| Number Of Beneficiaries Age 75 to 84 | 957 |
| Number Of Beneficiaries Age Greater 84 | 398 |
| Number Of Female Beneficiaries | 2123 |
| Number Of Male Beneficiaries | 1285 |
| Number Of Non Hispanic White Beneficiaries | 3050 |
| Number Of Black or African American Beneficiaries | 59 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | 236 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2400 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1008 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3138 |