National Provider Identifier [NPI]: |
1083626931 |
Last Name Of The Provider |
BOWERS |
First Name Of The Provider |
ELYN |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1264 HAWKS FLIGHT CT |
Street Address 2 Of The Provider |
SUIE 100 |
City Of The Provider |
EL DORADO HILLS |
Zip Code Of The Provider |
957629348 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
2142 |
Number Of Medicare Beneficiaries |
708 |
Total Submitted Charge Amount |
228318.87 |
Total Medicare Allowed Amount |
132495.84 |
Total Medicare Payment Amount |
88912.94 |
Total Medicare Standardized Payment Amount |
90002 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
25 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
7293.79 |
Total Drug Medicare AllowedAmount |
4530.33 |
Total Drug Medicare PaymentAmount |
3254.96 |
Total Drug Medicare Standardized Payment Amount |
3254.96 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
2117 |
Number Of Medicare Beneficiaries With Medical Services |
708 |
Total Medical Submitted Charge Amount |
221025.08 |
Total Medical Medicare Allowed Amount |
127965.51 |
Total Medical Medicare Payment Amount |
85657.98 |
Total Medical Medicare Standardized Payment Amount |
86747.04 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
50 |
Number Of Beneficiaries Age 65 to 74 |
327 |
Number Of Beneficiaries Age 75 to 84 |
213 |
Number Of Beneficiaries Age Greater 84 |
118 |
Number Of Female Beneficiaries |
405 |
Number Of Male Beneficiaries |
303 |
Number Of Non Hispanic White Beneficiaries |
678 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
642 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
66 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0701 |