| National Provider Identifier [NPI]: | 1114107935 |
| Last Name Of The Provider | JOSE |
| First Name Of The Provider | POWELL |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5301 F STREET |
| Street Address 2 Of The Provider | #117 |
| City Of The Provider | SACRAMENTO |
| Zip Code Of The Provider | 95819 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 2049 |
| Number Of Medicare Beneficiaries | 859 |
| Total Submitted Charge Amount | 669213 |
| Total Medicare Allowed Amount | 201559.2 |
| Total Medicare Payment Amount | 155889.01 |
| Total Medicare Standardized Payment Amount | 150856.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 255 |
| Number Of Medicare Beneficiaries With Drug Services | 64 |
| Total Drug Submitted ChargeAmount | 23404 |
| Total Drug Medicare AllowedAmount | 13339.13 |
| Total Drug Medicare PaymentAmount | 10457.85 |
| Total Drug Medicare Standardized Payment Amount | 10457.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 1794 |
| Number Of Medicare Beneficiaries With Medical Services | 859 |
| Total Medical Submitted Charge Amount | 645809 |
| Total Medical Medicare Allowed Amount | 188220.07 |
| Total Medical Medicare Payment Amount | 145431.16 |
| Total Medical Medicare Standardized Payment Amount | 140398.82 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 125 |
| Number Of Beneficiaries Age 65 to 74 | 303 |
| Number Of Beneficiaries Age 75 to 84 | 268 |
| Number Of Beneficiaries Age Greater 84 | 163 |
| Number Of Female Beneficiaries | 448 |
| Number Of Male Beneficiaries | 411 |
| Number Of Non Hispanic White Beneficiaries | 612 |
| Number Of Black or African American Beneficiaries | 81 |
| Number Of AsianPacific Islander Beneficiaries | 62 |
| Number Of Hispanic Beneficiaries | 76 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 610 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 249 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.7047 |