| National Provider Identifier [NPI]: | 1093733495 |
| Last Name Of The Provider | FOWLER |
| First Name Of The Provider | AMBER |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1600 CONTINENTAL PL |
| Street Address 2 Of The Provider | SUITE # 101 |
| City Of The Provider | MOUNT VERNON |
| Zip Code Of The Provider | 982735607 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 17271 |
| Number Of Medicare Beneficiaries | 1762 |
| Total Submitted Charge Amount | 2557806 |
| Total Medicare Allowed Amount | 1202969.14 |
| Total Medicare Payment Amount | 899393.23 |
| Total Medicare Standardized Payment Amount | 887651.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 75 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 600 |
| Total Drug Medicare AllowedAmount | 133.82 |
| Total Drug Medicare PaymentAmount | 97.33 |
| Total Drug Medicare Standardized Payment Amount | 97.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 91 |
| Number Of Medical Services | 17196 |
| Number Of Medicare Beneficiaries With Medical Services | 1762 |
| Total Medical Submitted Charge Amount | 2557206 |
| Total Medical Medicare Allowed Amount | 1202835.32 |
| Total Medical Medicare Payment Amount | 899295.9 |
| Total Medical Medicare Standardized Payment Amount | 887553.77 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 840 |
| Number Of Beneficiaries Age 75 to 84 | 663 |
| Number Of Beneficiaries Age Greater 84 | 229 |
| Number Of Female Beneficiaries | 869 |
| Number Of Male Beneficiaries | 893 |
| Number Of Non Hispanic White Beneficiaries | 1707 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1730 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 32 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.826 |