| National Provider Identifier [NPI]: | 1174511919 |
| Last Name Of The Provider | DAVENPORT |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2751 DEBARR RD |
| Street Address 2 Of The Provider | SUITE 390 |
| City Of The Provider | ANCHORAGE |
| Zip Code Of The Provider | 995082952 |
| State Code Of The Provider | AK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 163 |
| Number Of Services | 4097 |
| Number Of Medicare Beneficiaries | 2273 |
| Total Submitted Charge Amount | 697351 |
| Total Medicare Allowed Amount | 153280.26 |
| Total Medicare Payment Amount | 119353.22 |
| Total Medicare Standardized Payment Amount | 89050.59 |
| 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 | 163 |
| Number Of Medical Services | 4097 |
| Number Of Medicare Beneficiaries With Medical Services | 2273 |
| Total Medical Submitted Charge Amount | 697351 |
| Total Medical Medicare Allowed Amount | 153280.26 |
| Total Medical Medicare Payment Amount | 119353.22 |
| Total Medical Medicare Standardized Payment Amount | 89050.59 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 478 |
| Number Of Beneficiaries Age 65 to 74 | 937 |
| Number Of Beneficiaries Age 75 to 84 | 574 |
| Number Of Beneficiaries Age Greater 84 | 284 |
| Number Of Female Beneficiaries | 1327 |
| Number Of Male Beneficiaries | 946 |
| Number Of Non Hispanic White Beneficiaries | 1845 |
| Number Of Black or African American Beneficiaries | 92 |
| Number Of AsianPacific Islander Beneficiaries | 97 |
| Number Of Hispanic Beneficiaries | 71 |
| Number Of American Indian Alaska Native Beneficiaries | 124 |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1472 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 801 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4069 |