| National Provider Identifier [NPI]: | 1043200504 |
| Last Name Of The Provider | ROWE |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 65 SOCKANOSSET CROSSROADS |
| Street Address 2 Of The Provider | |
| City Of The Provider | CRANSTON |
| Zip Code Of The Provider | 029206068 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 164 |
| Number Of Services | 9138 |
| Number Of Medicare Beneficiaries | 3284 |
| Total Submitted Charge Amount | 1084478 |
| Total Medicare Allowed Amount | 210092.87 |
| Total Medicare Payment Amount | 162662.59 |
| Total Medicare Standardized Payment Amount | 160880.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3492 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 4903 |
| Total Drug Medicare AllowedAmount | 1325.47 |
| Total Drug Medicare PaymentAmount | 1039.15 |
| Total Drug Medicare Standardized Payment Amount | 1039.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 161 |
| Number Of Medical Services | 5646 |
| Number Of Medicare Beneficiaries With Medical Services | 3284 |
| Total Medical Submitted Charge Amount | 1079575 |
| Total Medical Medicare Allowed Amount | 208767.4 |
| Total Medical Medicare Payment Amount | 161623.44 |
| Total Medical Medicare Standardized Payment Amount | 159841.05 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 817 |
| Number Of Beneficiaries Age 65 to 74 | 1008 |
| Number Of Beneficiaries Age 75 to 84 | 745 |
| Number Of Beneficiaries Age Greater 84 | 714 |
| Number Of Female Beneficiaries | 2119 |
| Number Of Male Beneficiaries | 1165 |
| Number Of Non Hispanic White Beneficiaries | 2946 |
| Number Of Black or African American Beneficiaries | 62 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 186 |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | 55 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2100 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1184 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7252 |