| National Provider Identifier [NPI]: | 1295911469 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | JASON |
| 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 | 7910 FROST ST STE 250 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921232752 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 4717 |
| Number Of Medicare Beneficiaries | 683 |
| Total Submitted Charge Amount | 762628.24 |
| Total Medicare Allowed Amount | 508510.63 |
| Total Medicare Payment Amount | 390884.74 |
| Total Medicare Standardized Payment Amount | 350386.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 313 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 8709 |
| Total Drug Medicare AllowedAmount | 3882.98 |
| Total Drug Medicare PaymentAmount | 2962.38 |
| Total Drug Medicare Standardized Payment Amount | 2962.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 4404 |
| Number Of Medicare Beneficiaries With Medical Services | 683 |
| Total Medical Submitted Charge Amount | 753919.24 |
| Total Medical Medicare Allowed Amount | 504627.65 |
| Total Medical Medicare Payment Amount | 387922.36 |
| Total Medical Medicare Standardized Payment Amount | 347423.85 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 249 |
| Number Of Beneficiaries Age 65 to 74 | 206 |
| Number Of Beneficiaries Age 75 to 84 | 155 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 319 |
| Number Of Male Beneficiaries | 364 |
| Number Of Non Hispanic White Beneficiaries | 244 |
| Number Of Black or African American Beneficiaries | 103 |
| Number Of AsianPacific Islander Beneficiaries | 75 |
| Number Of Hispanic Beneficiaries | 230 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 281 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 402 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 67 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 72 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 6.3816 |