| National Provider Identifier [NPI]: | 1104966043 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | ERICA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | P.A. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2004 N HWY 81 |
| Street Address 2 Of The Provider | |
| City Of The Provider | DUNCAN |
| Zip Code Of The Provider | 735331460 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 1016 |
| Number Of Medicare Beneficiaries | 362 |
| Total Submitted Charge Amount | 71225 |
| Total Medicare Allowed Amount | 36002.35 |
| Total Medicare Payment Amount | 22750.4 |
| Total Medicare Standardized Payment Amount | 29960.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 330 |
| Number Of Medicare Beneficiaries With Drug Services | 109 |
| Total Drug Submitted ChargeAmount | 3597 |
| Total Drug Medicare AllowedAmount | 1180.49 |
| Total Drug Medicare PaymentAmount | 759.16 |
| Total Drug Medicare Standardized Payment Amount | 759.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 686 |
| Number Of Medicare Beneficiaries With Medical Services | 362 |
| Total Medical Submitted Charge Amount | 67628 |
| Total Medical Medicare Allowed Amount | 34821.86 |
| Total Medical Medicare Payment Amount | 21991.24 |
| Total Medical Medicare Standardized Payment Amount | 29201.29 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 154 |
| Number Of Beneficiaries Age 75 to 84 | 111 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 228 |
| Number Of Male Beneficiaries | 134 |
| Number Of Non Hispanic White Beneficiaries | 333 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 305 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9956 |