| National Provider Identifier [NPI]: | 1760717771 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | PRISCILLA |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | APN-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 615 HOPE RD |
| Street Address 2 Of The Provider | BUILDING 5 |
| City Of The Provider | EATONTOWN |
| Zip Code Of The Provider | 077241277 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 905 |
| Number Of Medicare Beneficiaries | 147 |
| Total Submitted Charge Amount | 114209.51 |
| Total Medicare Allowed Amount | 96987.16 |
| Total Medicare Payment Amount | 71032.84 |
| Total Medicare Standardized Payment Amount | 79739.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 46 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 758.32 |
| Total Drug Medicare AllowedAmount | 758.32 |
| Total Drug Medicare PaymentAmount | 743.05 |
| Total Drug Medicare Standardized Payment Amount | 743.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 859 |
| Number Of Medicare Beneficiaries With Medical Services | 147 |
| Total Medical Submitted Charge Amount | 113451.19 |
| Total Medical Medicare Allowed Amount | 96228.84 |
| Total Medical Medicare Payment Amount | 70289.79 |
| Total Medical Medicare Standardized Payment Amount | 78996.15 |
| Average Age Of Beneficiaries | 84 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 12 |
| Number Of Beneficiaries Age 75 to 84 | 40 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 95 |
| Number Of Male Beneficiaries | 52 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 126 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 51 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 70 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.208 |