| National Provider Identifier [NPI]: | 1962443176 |
| Last Name Of The Provider | DAVEY |
| First Name Of The Provider | NEIL |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1055 N CURTIS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BOISE |
| Zip Code Of The Provider | 837061309 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 195 |
| Number Of Services | 7463 |
| Number Of Medicare Beneficiaries | 1568 |
| Total Submitted Charge Amount | 380989.77 |
| Total Medicare Allowed Amount | 164630.14 |
| Total Medicare Payment Amount | 122762.88 |
| Total Medicare Standardized Payment Amount | 133963.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 5294 |
| Number Of Medicare Beneficiaries With Drug Services | 106 |
| Total Drug Submitted ChargeAmount | 2761.39 |
| Total Drug Medicare AllowedAmount | 2541.6 |
| Total Drug Medicare PaymentAmount | 1928.96 |
| Total Drug Medicare Standardized Payment Amount | 1928.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 183 |
| Number Of Medical Services | 2169 |
| Number Of Medicare Beneficiaries With Medical Services | 1568 |
| Total Medical Submitted Charge Amount | 378228.38 |
| Total Medical Medicare Allowed Amount | 162088.54 |
| Total Medical Medicare Payment Amount | 120833.92 |
| Total Medical Medicare Standardized Payment Amount | 132034.53 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 386 |
| Number Of Beneficiaries Age 65 to 74 | 542 |
| Number Of Beneficiaries Age 75 to 84 | 435 |
| Number Of Beneficiaries Age Greater 84 | 205 |
| Number Of Female Beneficiaries | 887 |
| Number Of Male Beneficiaries | 681 |
| Number Of Non Hispanic White Beneficiaries | 1428 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 90 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1070 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 498 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.591 |