| National Provider Identifier [NPI]: | 1194822726 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | KERN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4563 CENTRAL AVE |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | ST PETERSBURG |
| Zip Code Of The Provider | 337138137 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 3283 |
| Number Of Medicare Beneficiaries | 1211 |
| Total Submitted Charge Amount | 438277.73 |
| Total Medicare Allowed Amount | 108676.11 |
| Total Medicare Payment Amount | 84863.21 |
| Total Medicare Standardized Payment Amount | 73329.87 |
| 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 | 36 |
| Number Of Medical Services | 3283 |
| Number Of Medicare Beneficiaries With Medical Services | 1211 |
| Total Medical Submitted Charge Amount | 438277.73 |
| Total Medical Medicare Allowed Amount | 108676.11 |
| Total Medical Medicare Payment Amount | 84863.21 |
| Total Medical Medicare Standardized Payment Amount | 73329.87 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 203 |
| Number Of Beneficiaries Age 65 to 74 | 406 |
| Number Of Beneficiaries Age 75 to 84 | 390 |
| Number Of Beneficiaries Age Greater 84 | 212 |
| Number Of Female Beneficiaries | 692 |
| Number Of Male Beneficiaries | 519 |
| Number Of Non Hispanic White Beneficiaries | 995 |
| Number Of Black or African American Beneficiaries | 161 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 874 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 337 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.1918 |