National Provider Identifier [NPI]: |
1508854761 |
Last Name Of The Provider |
COWELL |
First Name Of The Provider |
VINCENT |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3401 N BROAD ST |
Street Address 2 Of The Provider |
3RD FL OUT PATIENT BUILDING |
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191405103 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
113 |
Number Of Medicare Beneficiaries |
109 |
Total Submitted Charge Amount |
153656.28 |
Total Medicare Allowed Amount |
23757.94 |
Total Medicare Payment Amount |
18425.72 |
Total Medicare Standardized Payment Amount |
17531.11 |
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 |
39 |
Number Of Medical Services |
113 |
Number Of Medicare Beneficiaries With Medical Services |
109 |
Total Medical Submitted Charge Amount |
153656.28 |
Total Medical Medicare Allowed Amount |
23757.94 |
Total Medical Medicare Payment Amount |
18425.72 |
Total Medical Medicare Standardized Payment Amount |
17531.11 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
38 |
Number Of Beneficiaries Age 65 to 74 |
44 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
57 |
Number Of Male Beneficiaries |
52 |
Number Of Non Hispanic White Beneficiaries |
56 |
Number Of Black or African American Beneficiaries |
41 |
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 |
57 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
52 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
42 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.3403 |