| National Provider Identifier [NPI]: | 1972545143 |
| Last Name Of The Provider | DAVILA |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 629 SW 153RD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BURIEN |
| Zip Code Of The Provider | 981662216 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 593 |
| Number Of Medicare Beneficiaries | 275 |
| Total Submitted Charge Amount | 34734.3 |
| Total Medicare Allowed Amount | 17568.82 |
| Total Medicare Payment Amount | 15047.71 |
| Total Medicare Standardized Payment Amount | 15159.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 198 |
| Number Of Medicare Beneficiaries With Drug Services | 162 |
| Total Drug Submitted ChargeAmount | 6049 |
| Total Drug Medicare AllowedAmount | 3549.64 |
| Total Drug Medicare PaymentAmount | 3379.86 |
| Total Drug Medicare Standardized Payment Amount | 3379.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 395 |
| Number Of Medicare Beneficiaries With Medical Services | 274 |
| Total Medical Submitted Charge Amount | 28685.3 |
| Total Medical Medicare Allowed Amount | 14019.18 |
| Total Medical Medicare Payment Amount | 11667.85 |
| Total Medical Medicare Standardized Payment Amount | 11779.69 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 68 |
| Number Of Beneficiaries Age 75 to 84 | 111 |
| Number Of Beneficiaries Age Greater 84 | 77 |
| Number Of Female Beneficiaries | 161 |
| Number Of Male Beneficiaries | 114 |
| Number Of Non Hispanic White Beneficiaries | 244 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 236 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1256 |