| National Provider Identifier [NPI]: | 1679572820 |
| Last Name Of The Provider | FOWLER |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3601 TVC |
| Street Address 2 Of The Provider | |
| City Of The Provider | NASHVILLE |
| Zip Code Of The Provider | 372320001 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 108 |
| Number Of Services | 16868 |
| Number Of Medicare Beneficiaries | 986 |
| Total Submitted Charge Amount | 630942 |
| Total Medicare Allowed Amount | 152329.81 |
| Total Medicare Payment Amount | 115039.8 |
| Total Medicare Standardized Payment Amount | 129358.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 15434 |
| Number Of Medicare Beneficiaries With Drug Services | 172 |
| Total Drug Submitted ChargeAmount | 20837 |
| Total Drug Medicare AllowedAmount | 5248.48 |
| Total Drug Medicare PaymentAmount | 4064.43 |
| Total Drug Medicare Standardized Payment Amount | 4064.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 101 |
| Number Of Medical Services | 1434 |
| Number Of Medicare Beneficiaries With Medical Services | 986 |
| Total Medical Submitted Charge Amount | 610105 |
| Total Medical Medicare Allowed Amount | 147081.33 |
| Total Medical Medicare Payment Amount | 110975.37 |
| Total Medical Medicare Standardized Payment Amount | 125294.14 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 251 |
| Number Of Beneficiaries Age 65 to 74 | 460 |
| Number Of Beneficiaries Age 75 to 84 | 211 |
| Number Of Beneficiaries Age Greater 84 | 64 |
| Number Of Female Beneficiaries | 536 |
| Number Of Male Beneficiaries | 450 |
| Number Of Non Hispanic White Beneficiaries | 867 |
| Number Of Black or African American Beneficiaries | 94 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 811 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 175 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.56 |