| National Provider Identifier [NPI]: | 1093998973 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13590 JOG ROAD |
| Street Address 2 Of The Provider | STE 5 |
| City Of The Provider | DELRAY BEACH |
| Zip Code Of The Provider | 33446 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 7276 |
| Number Of Medicare Beneficiaries | 1431 |
| Total Submitted Charge Amount | 252194 |
| Total Medicare Allowed Amount | 174612.93 |
| Total Medicare Payment Amount | 132492.4 |
| Total Medicare Standardized Payment Amount | 146273.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 68 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 2301 |
| Total Drug Medicare AllowedAmount | 1149.71 |
| Total Drug Medicare PaymentAmount | 1115.02 |
| Total Drug Medicare Standardized Payment Amount | 1115.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 7208 |
| Number Of Medicare Beneficiaries With Medical Services | 1431 |
| Total Medical Submitted Charge Amount | 249893 |
| Total Medical Medicare Allowed Amount | 173463.22 |
| Total Medical Medicare Payment Amount | 131377.38 |
| Total Medical Medicare Standardized Payment Amount | 145158.48 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 321 |
| Number Of Beneficiaries Age 75 to 84 | 605 |
| Number Of Beneficiaries Age Greater 84 | 486 |
| Number Of Female Beneficiaries | 942 |
| Number Of Male Beneficiaries | 489 |
| Number Of Non Hispanic White Beneficiaries | 1392 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1399 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 74 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4898 |