| National Provider Identifier [NPI]: | 1760432546 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 50 MEDICAL PARK DR E |
| Street Address 2 Of The Provider | |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 352353401 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 211 |
| Number Of Services | 10138 |
| Number Of Medicare Beneficiaries | 4177 |
| Total Submitted Charge Amount | 978579 |
| Total Medicare Allowed Amount | 245481.84 |
| Total Medicare Payment Amount | 194117 |
| Total Medicare Standardized Payment Amount | 211847.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3256 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 3146 |
| Total Drug Medicare AllowedAmount | 817.2 |
| Total Drug Medicare PaymentAmount | 640.77 |
| Total Drug Medicare Standardized Payment Amount | 640.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 208 |
| Number Of Medical Services | 6882 |
| Number Of Medicare Beneficiaries With Medical Services | 4177 |
| Total Medical Submitted Charge Amount | 975433 |
| Total Medical Medicare Allowed Amount | 244664.64 |
| Total Medical Medicare Payment Amount | 193476.23 |
| Total Medical Medicare Standardized Payment Amount | 211206.71 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 859 |
| Number Of Beneficiaries Age 65 to 74 | 1422 |
| Number Of Beneficiaries Age 75 to 84 | 1243 |
| Number Of Beneficiaries Age Greater 84 | 653 |
| Number Of Female Beneficiaries | 2597 |
| Number Of Male Beneficiaries | 1580 |
| Number Of Non Hispanic White Beneficiaries | 3793 |
| Number Of Black or African American Beneficiaries | 335 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3180 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 997 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6039 |