| National Provider Identifier [NPI]: | 1932197803 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 CATAMORE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | EAST PROVIDENCE |
| Zip Code Of The Provider | 029141204 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 144 |
| Number Of Services | 28428 |
| Number Of Medicare Beneficiaries | 2929 |
| Total Submitted Charge Amount | 1533764.25 |
| Total Medicare Allowed Amount | 361110.15 |
| Total Medicare Payment Amount | 272379.28 |
| Total Medicare Standardized Payment Amount | 264843.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 24280 |
| Number Of Medicare Beneficiaries With Drug Services | 233 |
| Total Drug Submitted ChargeAmount | 21184.25 |
| Total Drug Medicare AllowedAmount | 7880.97 |
| Total Drug Medicare PaymentAmount | 6178.38 |
| Total Drug Medicare Standardized Payment Amount | 6178.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 141 |
| Number Of Medical Services | 4148 |
| Number Of Medicare Beneficiaries With Medical Services | 2929 |
| Total Medical Submitted Charge Amount | 1512580 |
| Total Medical Medicare Allowed Amount | 353229.18 |
| Total Medical Medicare Payment Amount | 266200.9 |
| Total Medical Medicare Standardized Payment Amount | 258665.14 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 630 |
| Number Of Beneficiaries Age 65 to 74 | 1150 |
| Number Of Beneficiaries Age 75 to 84 | 734 |
| Number Of Beneficiaries Age Greater 84 | 415 |
| Number Of Female Beneficiaries | 1841 |
| Number Of Male Beneficiaries | 1088 |
| Number Of Non Hispanic White Beneficiaries | 2400 |
| Number Of Black or African American Beneficiaries | 150 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 293 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 57 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2016 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 913 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.4207 |