| National Provider Identifier [NPI]: | 1831312099 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3901 W 15TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PLANO |
| Zip Code Of The Provider | 750757738 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 185 |
| Number Of Services | 4932 |
| Number Of Medicare Beneficiaries | 3288 |
| Total Submitted Charge Amount | 710631.55 |
| Total Medicare Allowed Amount | 156237.43 |
| Total Medicare Payment Amount | 118379.09 |
| Total Medicare Standardized Payment Amount | 122467.27 |
| 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 | 185 |
| Number Of Medical Services | 4932 |
| Number Of Medicare Beneficiaries With Medical Services | 3288 |
| Total Medical Submitted Charge Amount | 710631.55 |
| Total Medical Medicare Allowed Amount | 156237.43 |
| Total Medical Medicare Payment Amount | 118379.09 |
| Total Medical Medicare Standardized Payment Amount | 122467.27 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 529 |
| Number Of Beneficiaries Age 65 to 74 | 1087 |
| Number Of Beneficiaries Age 75 to 84 | 1029 |
| Number Of Beneficiaries Age Greater 84 | 643 |
| Number Of Female Beneficiaries | 1968 |
| Number Of Male Beneficiaries | 1320 |
| Number Of Non Hispanic White Beneficiaries | 2770 |
| Number Of Black or African American Beneficiaries | 227 |
| Number Of AsianPacific Islander Beneficiaries | 87 |
| Number Of Hispanic Beneficiaries | 155 |
| Number Of American Indian Alaska Native Beneficiaries | 17 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2533 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 755 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.977 |