| National Provider Identifier [NPI]: | 1114001583 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | ALONZO |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 221A PROFESSIONAL CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOREHEAD CITY |
| Zip Code Of The Provider | 285574303 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 110 |
| Number Of Services | 15688.7 |
| Number Of Medicare Beneficiaries | 1124 |
| Total Submitted Charge Amount | 1029039.66 |
| Total Medicare Allowed Amount | 721548.87 |
| Total Medicare Payment Amount | 523617.14 |
| Total Medicare Standardized Payment Amount | 518045.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 4742.7 |
| Number Of Medicare Beneficiaries With Drug Services | 476 |
| Total Drug Submitted ChargeAmount | 59362.5 |
| Total Drug Medicare AllowedAmount | 11171.06 |
| Total Drug Medicare PaymentAmount | 9469.95 |
| Total Drug Medicare Standardized Payment Amount | 9469.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 10946 |
| Number Of Medicare Beneficiaries With Medical Services | 1124 |
| Total Medical Submitted Charge Amount | 969677.16 |
| Total Medical Medicare Allowed Amount | 710377.81 |
| Total Medical Medicare Payment Amount | 514147.19 |
| Total Medical Medicare Standardized Payment Amount | 508575.09 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 523 |
| Number Of Beneficiaries Age 75 to 84 | 350 |
| Number Of Beneficiaries Age Greater 84 | 152 |
| Number Of Female Beneficiaries | 621 |
| Number Of Male Beneficiaries | 503 |
| Number Of Non Hispanic White Beneficiaries | 1081 |
| Number Of Black or African American Beneficiaries | 25 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 983 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 141 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 63 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2003 |