National Provider Identifier [NPI]: |
1063462216 |
Last Name Of The Provider |
COWLES |
First Name Of The Provider |
DANA |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1856 ALAQUA DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
LONGWOOD |
Zip Code Of The Provider |
327793103 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
1880 |
Number Of Medicare Beneficiaries |
1227 |
Total Submitted Charge Amount |
1305631 |
Total Medicare Allowed Amount |
228926.58 |
Total Medicare Payment Amount |
175416.66 |
Total Medicare Standardized Payment Amount |
172169.45 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
1880 |
Number Of Medicare Beneficiaries With Medical Services |
1227 |
Total Medical Submitted Charge Amount |
1305631 |
Total Medical Medicare Allowed Amount |
228926.58 |
Total Medical Medicare Payment Amount |
175416.66 |
Total Medical Medicare Standardized Payment Amount |
172169.45 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
186 |
Number Of Beneficiaries Age 65 to 74 |
371 |
Number Of Beneficiaries Age 75 to 84 |
411 |
Number Of Beneficiaries Age Greater 84 |
259 |
Number Of Female Beneficiaries |
645 |
Number Of Male Beneficiaries |
582 |
Number Of Non Hispanic White Beneficiaries |
1048 |
Number Of Black or African American Beneficiaries |
112 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
50 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
957 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
270 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
1.9672 |