| National Provider Identifier [NPI]: | 1174583199 |
| Last Name Of The Provider | POW |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3950 HOLLYWOOD RD |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | SAINT JOSEPH |
| Zip Code Of The Provider | 490859159 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 123 |
| Number Of Services | 11423 |
| Number Of Medicare Beneficiaries | 2621 |
| Total Submitted Charge Amount | 4431963.02 |
| Total Medicare Allowed Amount | 1682484.25 |
| Total Medicare Payment Amount | 1267017.6 |
| Total Medicare Standardized Payment Amount | 1331392.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1283 |
| Number Of Medicare Beneficiaries With Drug Services | 419 |
| Total Drug Submitted ChargeAmount | 244175 |
| Total Drug Medicare AllowedAmount | 66929.59 |
| Total Drug Medicare PaymentAmount | 51856.43 |
| Total Drug Medicare Standardized Payment Amount | 51856.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 120 |
| Number Of Medical Services | 10140 |
| Number Of Medicare Beneficiaries With Medical Services | 2621 |
| Total Medical Submitted Charge Amount | 4187788.02 |
| Total Medical Medicare Allowed Amount | 1615554.66 |
| Total Medical Medicare Payment Amount | 1215161.17 |
| Total Medical Medicare Standardized Payment Amount | 1279536.26 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 323 |
| Number Of Beneficiaries Age 65 to 74 | 889 |
| Number Of Beneficiaries Age 75 to 84 | 934 |
| Number Of Beneficiaries Age Greater 84 | 475 |
| Number Of Female Beneficiaries | 1309 |
| Number Of Male Beneficiaries | 1312 |
| Number Of Non Hispanic White Beneficiaries | 2186 |
| Number Of Black or African American Beneficiaries | 373 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2093 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 528 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5446 |