| National Provider Identifier [NPI]: | 1871565085 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | TROY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | D. O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 413 N CHICAGO ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LITCHFIELD |
| Zip Code Of The Provider | 492529792 |
| 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 | 38 |
| Number Of Services | 1566 |
| Number Of Medicare Beneficiaries | 266 |
| Total Submitted Charge Amount | 111316.1 |
| Total Medicare Allowed Amount | 103348.19 |
| Total Medicare Payment Amount | 74210.74 |
| Total Medicare Standardized Payment Amount | 83530.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 106 |
| Number Of Medicare Beneficiaries With Drug Services | 79 |
| Total Drug Submitted ChargeAmount | 2960.7 |
| Total Drug Medicare AllowedAmount | 1554.66 |
| Total Drug Medicare PaymentAmount | 1489.11 |
| Total Drug Medicare Standardized Payment Amount | 1489.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 1460 |
| Number Of Medicare Beneficiaries With Medical Services | 266 |
| Total Medical Submitted Charge Amount | 108355.4 |
| Total Medical Medicare Allowed Amount | 101793.53 |
| Total Medical Medicare Payment Amount | 72721.63 |
| Total Medical Medicare Standardized Payment Amount | 82041.48 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 100 |
| Number Of Beneficiaries Age 75 to 84 | 69 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 142 |
| Number Of Male Beneficiaries | 124 |
| Number Of Non Hispanic White Beneficiaries | 252 |
| Number Of Black or African American Beneficiaries | |
| 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 | 172 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 94 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4031 |