National Provider Identifier [NPI]: |
1386605491 |
Last Name Of The Provider |
DOW |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1111 WINDOVER RD. |
Street Address 2 Of The Provider |
|
City Of The Provider |
JONESBORO |
Zip Code Of The Provider |
72401 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
89 |
Number Of Services |
1774 |
Number Of Medicare Beneficiaries |
489 |
Total Submitted Charge Amount |
110607.58 |
Total Medicare Allowed Amount |
69913.73 |
Total Medicare Payment Amount |
45851.94 |
Total Medicare Standardized Payment Amount |
50544.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
13 |
Number Of Drug Services |
71 |
Number Of Medicare Beneficiaries With Drug Services |
29 |
Total Drug Submitted ChargeAmount |
2141.58 |
Total Drug Medicare AllowedAmount |
1478.51 |
Total Drug Medicare PaymentAmount |
1347.93 |
Total Drug Medicare Standardized Payment Amount |
1347.93 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
76 |
Number Of Medical Services |
1703 |
Number Of Medicare Beneficiaries With Medical Services |
489 |
Total Medical Submitted Charge Amount |
108466 |
Total Medical Medicare Allowed Amount |
68435.22 |
Total Medical Medicare Payment Amount |
44504.01 |
Total Medical Medicare Standardized Payment Amount |
49196.69 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
69 |
Number Of Beneficiaries Age 65 to 74 |
217 |
Number Of Beneficiaries Age 75 to 84 |
143 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
287 |
Number Of Male Beneficiaries |
202 |
Number Of Non Hispanic White Beneficiaries |
458 |
Number Of Black or African American Beneficiaries |
11 |
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
392 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0141 |