| National Provider Identifier [NPI]: | 1912997537 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 FRUIT ST |
| Street Address 2 Of The Provider | GRJ 5 |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021142696 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 488 |
| Number Of Medicare Beneficiaries | 182 |
| Total Submitted Charge Amount | 232680 |
| Total Medicare Allowed Amount | 69076.4 |
| Total Medicare Payment Amount | 51894.62 |
| Total Medicare Standardized Payment Amount | 48928.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 831 |
| Total Drug Medicare AllowedAmount | 584.69 |
| Total Drug Medicare PaymentAmount | 567.88 |
| Total Drug Medicare Standardized Payment Amount | 567.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 466 |
| Number Of Medicare Beneficiaries With Medical Services | 182 |
| Total Medical Submitted Charge Amount | 231849 |
| Total Medical Medicare Allowed Amount | 68491.71 |
| Total Medical Medicare Payment Amount | 51326.74 |
| Total Medical Medicare Standardized Payment Amount | 48360.21 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 49 |
| Number Of Male Beneficiaries | 133 |
| Number Of Non Hispanic White Beneficiaries | 143 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 74 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 108 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.9056 |