National Provider Identifier [NPI]: |
1316911084 |
Last Name Of The Provider |
BOWER |
First Name Of The Provider |
BRUCE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8745 AERO DR |
Street Address 2 Of The Provider |
STE 200 |
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921231774 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
199 |
Number Of Services |
15635 |
Number Of Medicare Beneficiaries |
2408 |
Total Submitted Charge Amount |
733668.15 |
Total Medicare Allowed Amount |
223742.16 |
Total Medicare Payment Amount |
163711.84 |
Total Medicare Standardized Payment Amount |
157656.69 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
11802 |
Number Of Medicare Beneficiaries With Drug Services |
102 |
Total Drug Submitted ChargeAmount |
15106.56 |
Total Drug Medicare AllowedAmount |
2193.53 |
Total Drug Medicare PaymentAmount |
1719.31 |
Total Drug Medicare Standardized Payment Amount |
1719.31 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
198 |
Number Of Medical Services |
3833 |
Number Of Medicare Beneficiaries With Medical Services |
2408 |
Total Medical Submitted Charge Amount |
718561.59 |
Total Medical Medicare Allowed Amount |
221548.63 |
Total Medical Medicare Payment Amount |
161992.53 |
Total Medical Medicare Standardized Payment Amount |
155937.38 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
325 |
Number Of Beneficiaries Age 65 to 74 |
882 |
Number Of Beneficiaries Age 75 to 84 |
749 |
Number Of Beneficiaries Age Greater 84 |
452 |
Number Of Female Beneficiaries |
1492 |
Number Of Male Beneficiaries |
916 |
Number Of Non Hispanic White Beneficiaries |
1429 |
Number Of Black or African American Beneficiaries |
142 |
Number Of AsianPacific Islander Beneficiaries |
319 |
Number Of Hispanic Beneficiaries |
445 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1526 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
882 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
23 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.9373 |