| National Provider Identifier [NPI]: | 1871588012 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | BRENT |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 619 S FLEISHEL AVE |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 757012004 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 102 |
| Number Of Services | 11488 |
| Number Of Medicare Beneficiaries | 2395 |
| Total Submitted Charge Amount | 2699267.33 |
| Total Medicare Allowed Amount | 665258.74 |
| Total Medicare Payment Amount | 504439.23 |
| Total Medicare Standardized Payment Amount | 532529.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 4698 |
| Number Of Medicare Beneficiaries With Drug Services | 150 |
| Total Drug Submitted ChargeAmount | 63431.85 |
| Total Drug Medicare AllowedAmount | 22594.99 |
| Total Drug Medicare PaymentAmount | 17627.39 |
| Total Drug Medicare Standardized Payment Amount | 17627.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 97 |
| Number Of Medical Services | 6790 |
| Number Of Medicare Beneficiaries With Medical Services | 2394 |
| Total Medical Submitted Charge Amount | 2635835.48 |
| Total Medical Medicare Allowed Amount | 642663.75 |
| Total Medical Medicare Payment Amount | 486811.84 |
| Total Medical Medicare Standardized Payment Amount | 514901.63 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 287 |
| Number Of Beneficiaries Age 65 to 74 | 954 |
| Number Of Beneficiaries Age 75 to 84 | 822 |
| Number Of Beneficiaries Age Greater 84 | 332 |
| Number Of Female Beneficiaries | 1204 |
| Number Of Male Beneficiaries | 1191 |
| Number Of Non Hispanic White Beneficiaries | 2085 |
| Number Of Black or African American Beneficiaries | 241 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1993 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 402 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4776 |