| National Provider Identifier [NPI]: | 1730190521 |
| Last Name Of The Provider | MUMBOWER |
| First Name Of The Provider | AMY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7703 FLOYD CURL DR |
| Street Address 2 Of The Provider | MD 7977 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782293901 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 15500 |
| Number Of Medicare Beneficiaries | 1465 |
| Total Submitted Charge Amount | 309141 |
| Total Medicare Allowed Amount | 87297.21 |
| Total Medicare Payment Amount | 63307.18 |
| Total Medicare Standardized Payment Amount | 74226.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 12800 |
| Number Of Medicare Beneficiaries With Drug Services | 114 |
| Total Drug Submitted ChargeAmount | 12800 |
| Total Drug Medicare AllowedAmount | 2396 |
| Total Drug Medicare PaymentAmount | 1824.1 |
| Total Drug Medicare Standardized Payment Amount | 1824.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 2700 |
| Number Of Medicare Beneficiaries With Medical Services | 1465 |
| Total Medical Submitted Charge Amount | 296341 |
| Total Medical Medicare Allowed Amount | 84901.21 |
| Total Medical Medicare Payment Amount | 61483.08 |
| Total Medical Medicare Standardized Payment Amount | 72402.34 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 453 |
| Number Of Beneficiaries Age 65 to 74 | 576 |
| Number Of Beneficiaries Age 75 to 84 | 316 |
| Number Of Beneficiaries Age Greater 84 | 120 |
| Number Of Female Beneficiaries | 720 |
| Number Of Male Beneficiaries | 745 |
| Number Of Non Hispanic White Beneficiaries | 759 |
| Number Of Black or African American Beneficiaries | 92 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 579 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 963 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 502 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.2939 |