| National Provider Identifier [NPI]: | 1215992359 |
| Last Name Of The Provider | FOWLER |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1414 116TH AVE NE |
| Street Address 2 Of The Provider | SUITE E |
| City Of The Provider | BELLEVUE |
| Zip Code Of The Provider | 980043801 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiac Electrophysiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 3047 |
| Number Of Medicare Beneficiaries | 1136 |
| Total Submitted Charge Amount | 507600.88 |
| Total Medicare Allowed Amount | 201992.31 |
| Total Medicare Payment Amount | 147885 |
| Total Medicare Standardized Payment Amount | 141423.33 |
| 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 | 66 |
| Number Of Medical Services | 3047 |
| Number Of Medicare Beneficiaries With Medical Services | 1136 |
| Total Medical Submitted Charge Amount | 507600.88 |
| Total Medical Medicare Allowed Amount | 201992.31 |
| Total Medical Medicare Payment Amount | 147885 |
| Total Medical Medicare Standardized Payment Amount | 141423.33 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 364 |
| Number Of Beneficiaries Age 75 to 84 | 420 |
| Number Of Beneficiaries Age Greater 84 | 306 |
| Number Of Female Beneficiaries | 564 |
| Number Of Male Beneficiaries | 572 |
| Number Of Non Hispanic White Beneficiaries | 1036 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 50 |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1000 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 136 |
| Percent Of With Atrial Fibrillation | 36 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4166 |