| National Provider Identifier [NPI]: | 1194715763 |
| Last Name Of The Provider | KOWAL |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2323 W ROSE GARDEN LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850272530 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 176 |
| Number Of Services | 8190 |
| Number Of Medicare Beneficiaries | 2603 |
| Total Submitted Charge Amount | 808741 |
| Total Medicare Allowed Amount | 220836.24 |
| Total Medicare Payment Amount | 164119.07 |
| Total Medicare Standardized Payment Amount | 167817.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 3978 |
| Number Of Medicare Beneficiaries With Drug Services | 58 |
| Total Drug Submitted ChargeAmount | 8352 |
| Total Drug Medicare AllowedAmount | 907.45 |
| Total Drug Medicare PaymentAmount | 711.06 |
| Total Drug Medicare Standardized Payment Amount | 711.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 173 |
| Number Of Medical Services | 4212 |
| Number Of Medicare Beneficiaries With Medical Services | 2603 |
| Total Medical Submitted Charge Amount | 800389 |
| Total Medical Medicare Allowed Amount | 219928.79 |
| Total Medical Medicare Payment Amount | 163408.01 |
| Total Medical Medicare Standardized Payment Amount | 167106.83 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 424 |
| Number Of Beneficiaries Age 65 to 74 | 1212 |
| Number Of Beneficiaries Age 75 to 84 | 689 |
| Number Of Beneficiaries Age Greater 84 | 278 |
| Number Of Female Beneficiaries | 1564 |
| Number Of Male Beneficiaries | 1039 |
| Number Of Non Hispanic White Beneficiaries | 1982 |
| Number Of Black or African American Beneficiaries | 148 |
| Number Of AsianPacific Islander Beneficiaries | 50 |
| Number Of Hispanic Beneficiaries | 356 |
| Number Of American Indian Alaska Native Beneficiaries | 29 |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2065 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 538 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7698 |