| National Provider Identifier [NPI]: | 1174526339 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | RANDALL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7695 POPLAR PIKE |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | GERMANTOWN |
| Zip Code Of The Provider | 381385947 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 171 |
| Number Of Services | 4629 |
| Number Of Medicare Beneficiaries | 2929 |
| Total Submitted Charge Amount | 680625.03 |
| Total Medicare Allowed Amount | 144419.69 |
| Total Medicare Payment Amount | 110824.08 |
| Total Medicare Standardized Payment Amount | 118499.3 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 628 |
| Number Of Beneficiaries Age 65 to 74 | 1148 |
| Number Of Beneficiaries Age 75 to 84 | 781 |
| Number Of Beneficiaries Age Greater 84 | 372 |
| Number Of Female Beneficiaries | 1870 |
| Number Of Male Beneficiaries | 1059 |
| Number Of Non Hispanic White Beneficiaries | 1798 |
| Number Of Black or African American Beneficiaries | 1081 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2133 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 796 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9153 |