| National Provider Identifier [NPI]: | 1003019191 |
| Last Name Of The Provider | WARREN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1108 ROSS CLARK CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOTHAN |
| Zip Code Of The Provider | 363013022 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 874 |
| Number Of Medicare Beneficiaries | 804 |
| Total Submitted Charge Amount | 657930.79 |
| Total Medicare Allowed Amount | 92487.66 |
| Total Medicare Payment Amount | 69123.96 |
| Total Medicare Standardized Payment Amount | 75512.86 |
| 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 | 95 |
| Number Of Medical Services | 874 |
| Number Of Medicare Beneficiaries With Medical Services | 804 |
| Total Medical Submitted Charge Amount | 657930.79 |
| Total Medical Medicare Allowed Amount | 92487.66 |
| Total Medical Medicare Payment Amount | 69123.96 |
| Total Medical Medicare Standardized Payment Amount | 75512.86 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 185 |
| Number Of Beneficiaries Age 65 to 74 | 362 |
| Number Of Beneficiaries Age 75 to 84 | 203 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 460 |
| Number Of Male Beneficiaries | 344 |
| Number Of Non Hispanic White Beneficiaries | 625 |
| Number Of Black or African American Beneficiaries | 166 |
| 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 | 591 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 213 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5023 |