| National Provider Identifier [NPI]: | 1760690416 |
| Last Name Of The Provider | KOWAL |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14 RICE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TEMPLETON |
| Zip Code Of The Provider | 014681332 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 167 |
| Number Of Services | 3251 |
| Number Of Medicare Beneficiaries | 2029 |
| Total Submitted Charge Amount | 314802 |
| Total Medicare Allowed Amount | 102917.54 |
| Total Medicare Payment Amount | 76134.95 |
| Total Medicare Standardized Payment Amount | 76219.9 |
| 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 | 167 |
| Number Of Medical Services | 3251 |
| Number Of Medicare Beneficiaries With Medical Services | 2029 |
| Total Medical Submitted Charge Amount | 314802 |
| Total Medical Medicare Allowed Amount | 102917.54 |
| Total Medical Medicare Payment Amount | 76134.95 |
| Total Medical Medicare Standardized Payment Amount | 76219.9 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 671 |
| Number Of Beneficiaries Age 65 to 74 | 605 |
| Number Of Beneficiaries Age 75 to 84 | 453 |
| Number Of Beneficiaries Age Greater 84 | 300 |
| Number Of Female Beneficiaries | 1126 |
| Number Of Male Beneficiaries | 903 |
| Number Of Non Hispanic White Beneficiaries | 1777 |
| Number Of Black or African American Beneficiaries | 60 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 138 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1056 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 973 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.693 |