| National Provider Identifier [NPI]: | 1285669911 |
| Last Name Of The Provider | DAVIES |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 602 W. UNIVERSITY AVENUE |
| Street Address 2 Of The Provider | NEUROLOGY |
| City Of The Provider | URBANA |
| Zip Code Of The Provider | 61801 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 846 |
| Number Of Medicare Beneficiaries | 438 |
| Total Submitted Charge Amount | 377564 |
| Total Medicare Allowed Amount | 66996.1 |
| Total Medicare Payment Amount | 48451.09 |
| Total Medicare Standardized Payment Amount | 50316.5 |
| 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 | 22 |
| Number Of Medical Services | 846 |
| Number Of Medicare Beneficiaries With Medical Services | 438 |
| Total Medical Submitted Charge Amount | 377564 |
| Total Medical Medicare Allowed Amount | 66996.1 |
| Total Medical Medicare Payment Amount | 48451.09 |
| Total Medical Medicare Standardized Payment Amount | 50316.5 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 143 |
| Number Of Beneficiaries Age 65 to 74 | 154 |
| Number Of Beneficiaries Age 75 to 84 | 111 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 233 |
| Number Of Male Beneficiaries | 205 |
| Number Of Non Hispanic White Beneficiaries | 376 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 318 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 120 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 1.4004 |