| National Provider Identifier [NPI]: | 1376514422 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | WESLEY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 201 4TH ST |
| Street Address 2 Of The Provider | SUITE 3B |
| City Of The Provider | ALEXANDRIA |
| Zip Code Of The Provider | 713018421 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 9350 |
| Number Of Medicare Beneficiaries | 1572 |
| Total Submitted Charge Amount | 2096424.72 |
| Total Medicare Allowed Amount | 660711.5 |
| Total Medicare Payment Amount | 493084.63 |
| Total Medicare Standardized Payment Amount | 524127.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1600 |
| Number Of Medicare Beneficiaries With Drug Services | 132 |
| Total Drug Submitted ChargeAmount | 57320 |
| Total Drug Medicare AllowedAmount | 25625.41 |
| Total Drug Medicare PaymentAmount | 19705.43 |
| Total Drug Medicare Standardized Payment Amount | 19705.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 7750 |
| Number Of Medicare Beneficiaries With Medical Services | 1572 |
| Total Medical Submitted Charge Amount | 2039104.72 |
| Total Medical Medicare Allowed Amount | 635086.09 |
| Total Medical Medicare Payment Amount | 473379.2 |
| Total Medical Medicare Standardized Payment Amount | 504422.13 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 222 |
| Number Of Beneficiaries Age 65 to 74 | 575 |
| Number Of Beneficiaries Age 75 to 84 | 539 |
| Number Of Beneficiaries Age Greater 84 | 236 |
| Number Of Female Beneficiaries | 827 |
| Number Of Male Beneficiaries | 745 |
| Number Of Non Hispanic White Beneficiaries | 1321 |
| Number Of Black or African American Beneficiaries | 224 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1150 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 422 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4898 |