| National Provider Identifier [NPI]: | 1619936945 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | KRISTY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 916 MYRTLE ST STE 200 |
| Street Address 2 Of The Provider | |
| City Of The Provider | STURGIS |
| Zip Code Of The Provider | 490912326 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 1034 |
| Number Of Medicare Beneficiaries | 234 |
| Total Submitted Charge Amount | 131816.79 |
| Total Medicare Allowed Amount | 74732.03 |
| Total Medicare Payment Amount | 53353.25 |
| Total Medicare Standardized Payment Amount | 56786.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 104 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 3161 |
| Total Drug Medicare AllowedAmount | 1275.43 |
| Total Drug Medicare PaymentAmount | 1205.51 |
| Total Drug Medicare Standardized Payment Amount | 1205.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 930 |
| Number Of Medicare Beneficiaries With Medical Services | 234 |
| Total Medical Submitted Charge Amount | 128655.79 |
| Total Medical Medicare Allowed Amount | 73456.6 |
| Total Medical Medicare Payment Amount | 52147.74 |
| Total Medical Medicare Standardized Payment Amount | 55581.19 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 126 |
| Number Of Beneficiaries Age 75 to 84 | 61 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 163 |
| Number Of Male Beneficiaries | 71 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 219 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9764 |