| National Provider Identifier [NPI]: | 1912949017 |
| Last Name Of The Provider | DAVIS |
| First Name Of The Provider | MARIA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | N.P. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 16111 PLUMMER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SEPULVEDA |
| Zip Code Of The Provider | 913432036 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 2136 |
| Number Of Medicare Beneficiaries | 503 |
| Total Submitted Charge Amount | 572343 |
| Total Medicare Allowed Amount | 137593.26 |
| Total Medicare Payment Amount | 104152.99 |
| Total Medicare Standardized Payment Amount | 114639.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 96 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 960 |
| Total Drug Medicare AllowedAmount | 171.59 |
| Total Drug Medicare PaymentAmount | 134.57 |
| Total Drug Medicare Standardized Payment Amount | 134.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 2040 |
| Number Of Medicare Beneficiaries With Medical Services | 503 |
| Total Medical Submitted Charge Amount | 571383 |
| Total Medical Medicare Allowed Amount | 137421.67 |
| Total Medical Medicare Payment Amount | 104018.42 |
| Total Medical Medicare Standardized Payment Amount | 114505.05 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 214 |
| Number Of Beneficiaries Age 65 to 74 | 149 |
| Number Of Beneficiaries Age 75 to 84 | 96 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 321 |
| Number Of Male Beneficiaries | 182 |
| Number Of Non Hispanic White Beneficiaries | 320 |
| Number Of Black or African American Beneficiaries | 106 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 63 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 178 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 325 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 22 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 45 |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 20 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.5718 |