| National Provider Identifier [NPI]: | 1275751612 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2120 GOLDEN HILL |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | PASO ROBLES |
| Zip Code Of The Provider | 934462120 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 3404 |
| Number Of Medicare Beneficiaries | 578 |
| Total Submitted Charge Amount | 276770.4 |
| Total Medicare Allowed Amount | 181784.16 |
| Total Medicare Payment Amount | 123512.16 |
| Total Medicare Standardized Payment Amount | 118745.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 519 |
| Number Of Medicare Beneficiaries With Drug Services | 220 |
| Total Drug Submitted ChargeAmount | 14872 |
| Total Drug Medicare AllowedAmount | 4408.55 |
| Total Drug Medicare PaymentAmount | 3933.97 |
| Total Drug Medicare Standardized Payment Amount | 3933.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 2885 |
| Number Of Medicare Beneficiaries With Medical Services | 577 |
| Total Medical Submitted Charge Amount | 261898.4 |
| Total Medical Medicare Allowed Amount | 177375.61 |
| Total Medical Medicare Payment Amount | 119578.19 |
| Total Medical Medicare Standardized Payment Amount | 114811.23 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 328 |
| Number Of Beneficiaries Age 75 to 84 | 163 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 288 |
| Number Of Male Beneficiaries | 290 |
| Number Of Non Hispanic White Beneficiaries | 545 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 563 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 3 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 34 |
| Percent Of With Ischemic Heart Disease | 14 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.7483 |