| National Provider Identifier [NPI]: | 1700862596 |
| Last Name Of The Provider | DAVIDOFF |
| First Name Of The Provider | ALAN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 320 CREEKSHIRE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SIGNAL MOUNTAIN |
| Zip Code Of The Provider | 373772086 |
| 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 | 77 |
| Number Of Services | 2430 |
| Number Of Medicare Beneficiaries | 1801 |
| Total Submitted Charge Amount | 184528 |
| Total Medicare Allowed Amount | 45342.29 |
| Total Medicare Payment Amount | 35141.95 |
| Total Medicare Standardized Payment Amount | 37190.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 2430 |
| Number Of Medicare Beneficiaries With Medical Services | 1801 |
| Total Medical Submitted Charge Amount | 184528 |
| Total Medical Medicare Allowed Amount | 45342.29 |
| Total Medical Medicare Payment Amount | 35141.95 |
| Total Medical Medicare Standardized Payment Amount | 37190.04 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 494 |
| Number Of Beneficiaries Age 65 to 74 | 519 |
| Number Of Beneficiaries Age 75 to 84 | 498 |
| Number Of Beneficiaries Age Greater 84 | 290 |
| Number Of Female Beneficiaries | 996 |
| Number Of Male Beneficiaries | 805 |
| Number Of Non Hispanic White Beneficiaries | 1434 |
| Number Of Black or African American Beneficiaries | 244 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 67 |
| Number Of American Indian Alaska Native Beneficiaries | 29 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 997 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 804 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 55 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 54 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.594 |