| National Provider Identifier [NPI]: | 1053381731 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2483 HIGHWAY 644 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOUISA |
| Zip Code Of The Provider | 41230 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 156 |
| Number Of Services | 7912 |
| Number Of Medicare Beneficiaries | 3727 |
| Total Submitted Charge Amount | 1043541 |
| Total Medicare Allowed Amount | 202568.65 |
| Total Medicare Payment Amount | 152075.04 |
| Total Medicare Standardized Payment Amount | 159641.2 |
| 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 | 156 |
| Number Of Medical Services | 7912 |
| Number Of Medicare Beneficiaries With Medical Services | 3727 |
| Total Medical Submitted Charge Amount | 1043541 |
| Total Medical Medicare Allowed Amount | 202568.65 |
| Total Medical Medicare Payment Amount | 152075.04 |
| Total Medical Medicare Standardized Payment Amount | 159641.2 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 1281 |
| Number Of Beneficiaries Age 65 to 74 | 1279 |
| Number Of Beneficiaries Age 75 to 84 | 789 |
| Number Of Beneficiaries Age Greater 84 | 378 |
| Number Of Female Beneficiaries | 2176 |
| Number Of Male Beneficiaries | 1551 |
| Number Of Non Hispanic White Beneficiaries | 3581 |
| Number Of Black or African American Beneficiaries | 105 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1933 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1794 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.374 |