| National Provider Identifier [NPI]: | 1487610507 |
| Last Name Of The Provider | DAVIDSON |
| First Name Of The Provider | MELANIE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 701 N STATE OF FRANKLIN RD |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | JOHNSON CITY |
| Zip Code Of The Provider | 376043645 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 4003 |
| Number Of Medicare Beneficiaries | 1138 |
| Total Submitted Charge Amount | 1304574.19 |
| Total Medicare Allowed Amount | 434397.71 |
| Total Medicare Payment Amount | 335785.74 |
| Total Medicare Standardized Payment Amount | 355286.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 208 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 33072 |
| Total Drug Medicare AllowedAmount | 10987.42 |
| Total Drug Medicare PaymentAmount | 8495.64 |
| Total Drug Medicare Standardized Payment Amount | 8495.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 3795 |
| Number Of Medicare Beneficiaries With Medical Services | 1138 |
| Total Medical Submitted Charge Amount | 1271502.19 |
| Total Medical Medicare Allowed Amount | 423410.29 |
| Total Medical Medicare Payment Amount | 327290.1 |
| Total Medical Medicare Standardized Payment Amount | 346790.93 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 210 |
| Number Of Beneficiaries Age 65 to 74 | 410 |
| Number Of Beneficiaries Age 75 to 84 | 341 |
| Number Of Beneficiaries Age Greater 84 | 177 |
| Number Of Female Beneficiaries | 645 |
| Number Of Male Beneficiaries | 493 |
| Number Of Non Hispanic White Beneficiaries | 1105 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 789 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 349 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.7401 |